Rental Application

826 I Road

P.O. Box 196

Larned KS 67550
Phone (620) 285-2951

Fax (866) 239-6089

Email Lisa@picketfence-realestate.com
Rental Application
Please make sure to click save when applicable.
Date of Application:
Prefered move in date:
Rent Range*

$400 -$500$500 -$600$600 - $700$700-$800$800-$900$1,000 - $1,200
Personal Information
*
Co Applicant Information
Pets*

YesNo
Type/Breed/Weight/Age
RESIDENCE HISTORY (Full address and phone numbers are required)
*
EMPLOYMENT INFORMATION
Check all that apply*

Full TimePart TimeStudentNot Employed
(You must submit proof of income 3 times greater than the total monthly rent to forgo)
Current Employer*
*
Co Applicant Employer
Nearest Relative livng Near you*
*
If there are other sources of income you would like us to consider, please list income, source and person (banker, employers,etc) who we would contract for confirmation. You do not have to reveal alimony, child support, or spouse’s annual income unless you want us to consider it on the application
$*
Per*
Source*
Phone
Vehicles
Other vehicles & motorcycles etc.
Bank & Credit References
*
Your Credit References*
Character References (atleast 3)
*
Have you or your spouce ever:
Been sued for nonpayment of rent*

YesNo
Been evicted or asked to move out?*

YesNo
Declared Bankruptcy*

YesNo
Broken a rental or lease agreement?*

YesNo
Been sued for damage to rental property?*

YesNo
Been convicted of a felony, or have pending charges?*

YesNo
If yes to any of the above, please explain:
Please give any additional information that might help management evaluate your application:
How did you find the online application?
If you selected referral above list the name or organization here.
IN CASE OF PERSOANL EMERGENCY
*
I HEREBY APPLY TO LEASE THE ABOVE DESCRIBED PREMISES FOR THE TERM AND UPON THE CONDITIONS ABOVE SET FORTH AND AGREE THAT THE RENT IS TO BE PAYALBE THE FIRST DAY OF EACH MONTH AND DELINQUENT ON THE 10TH DAY OF EACH MONTH. AS AN INDCUCEMENT TO THE OWNER OF THE PROPERTY AND TO THE AGENT TO ACCEPT THIS APPLICATION, I WARRANT THAT ALL STATEMENTS ABOVE SET FORTH ARE TRUE. I AUTHORIZE YOU TO CONTACT PREVIOUS LANDLORDS(S), CREDIT, AND PERSONAL REFERENCES THAT I HAVE GIVEN IN THIS APPLICATION. I ALSO AUTHORIZE MANAGEMENT TO OBTAIN MY CONSUMER CREDIT REPORT IF THEY SO WISH.

THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
Signature of Applicant*

Clear
Signature of Spouse

Clear
Should be Empty: