Individual Application

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VISTA PROPERTIES..............................................RENTAL APPLICATION


Phone: 501.270.0625 or 501.270.1044
Email:...akhughe@yahoo.com

Name______________________________________ Maiden Name_______________________


Social Security # ____________________________ Birth Date____________________

Are you a US Citizen? _____ Yes _____ No Number of Occupants___________________

Cell Phone#________________ Work Phone #___________________ Home Phone#______________
 

Email__________________________________________________



 Pets:..Number....................Type...................................Color...........Weight
......... ________.....________________________...._________ ___________

Occupants:
Name.................................................Birth date (mm-dd-yyyy)...........Social Security #......... Relationship

___________________________ _____________________ ____________________ _______________

___________________________ _____________________ ____________________ _______________

___________________________ _____________________ ____________________ _______________

___________________________ _____________________ ____________________ _______________

___________________________ _____________________ ____________________ _______________

Current Employer_____________________ Supervisor____________________ Phone #_________________

Date Employed__________________ Position______________________ Gross Salary/Month________

Previou Previous Employer___________________ Supervisor___________________ Phone #__________________

Employed From ________to________ Position______________________ Gross Salary/Month________


Emergency Contact__________________________ Street #____________________ City________________________

State_________ Zip______________ Phone #________________________Relationship___________________

Closest Relative_____________________________ Street #____________________ City________________________

State_________ Zip______________Phone #_________________________Relationship__________________

Have you ever been evicted?_______ Has Anyone ever been convicted of a Felony_______________

Current Residence_________________________________________________________________________

...............................................Street...............................................Apt#.....City...........................................State........Zip


Landlords Name ______________________________ Phone #______________________How long_________

Why are you leaving ?______________________________________________________

Was your Lease/Account in any other name?__________________________If yes, what name______________

Previous Residence_________________________________________________________________________

................................................Street...............................................Apt#....City...........................................State........Zip

Landlord's Name_______________________________ Phone #______________________ How long________

Have you ever broken a lease agreement? Yes / No


Vehicle_____________ _____________ ____________ _______________ _________ ________ ________$_______

.....................Year.................Make.................Model.................Registered to.......Tag#..........State.........Color...........Pymt

Drivers License #________________________________Expiration Date______________________State____________

Security Deposit $___________ Application Fee $_____________________________Total $______________________

Applicant represents that all of the above statements are true and complete and hereby authorizes verification of the above information, references and credit records. Applicant acknowledges that false information herein may constitute grounds for rejection of this application, termination of right of occupancy and/or fees charged and may constitute a criminal offense under the laws of this state.

Applicant__________________________________________Date____________

OWNER, BY ITS REPRESENTATIVE VISTA PROPERTIES________________________________Date_____________

Please print application form, fill out application and email it to Akhughe@yahoo.com