*Rental House - Apartment - Ann Arbor MI*

DOUBLE A PROPERTIES
734.678.3882

www.annarborhouserental.com

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RENTAL/CREDIT APPLICATION

$25.00 cash nonrefundable application fee for each adult

1. ABOUT YOU

NAME:

PRIOR NAMES:

CURRENT ADDRESS:

CITY:

STATE:

ZIP CODE:

HOME #:

MOBILE #:

BUSINESS #:

EMAIL ADDRESS:

SSN#:

DRIVER’S LICENSE # & STATE:

HOW LONG AT PRESENT ADDRESS?:

CURRENT RENT / MORTGAGE:

UTILITIES INCLUDED?   YES     NO

LANDLORD’S NAME:

PHONE #:

PREVIOUS ADDRESS:

PREVIOUS LANDLORD:

PHONE #:

EMPLOYER’S NAME:

SUPERVISOR:

BUSINESS ADDRESS:

PHONE #:

POSITION HELD:

HOW LONG?:

SALARY:    MONTHLY / YEARLY (circle one)

2. YOUR HOUSEHOLD

NUMBER OF PEOPLE WHO WOULD BE LIVING THERE IF THE HOUSE IF RENTED TO YOU?

CHILDREN?   YES        NO

IF YES, PLEASE LIST NAMES AND AGES:

ANY SMOKERS IN YOUR HOUSEHOLD?   YES     NO

ANY PETS?

YES   NO

IF SO, TYPE:

WEIGHT:

AGE:

TYPE:

WEIGHT:

AGE:

3. CREDIT/CRIMINAL INFORMATION

BANK NAME:

CHECKING?         YES     NO

ACCT #:

CREDIT CARDS?   YES     NO

PAST CREDIT PROBLEMS?

BANKRUPTCY?  YES   NO      IF YES, WHEN?

State:

ZIP Code:

EVER BEEN SERVED EVICTION NOTICE/ASKED TO LEAVE?   YES     NO

Monthly payment or rent:

How long?

EVER BEEN CONVICTED OF A FELONY?

RECEIVED DEFERRED ADJUDICATION FOR A FELONY?

4. OTHER INFORMATION

PLEASE LET US KNOW HOW YOU WERE REFERRED TO US:

I AM INTERESTED IN RENTING THE HOME AT ________________________________ AND I AM PROVIDING A $25 NONREFUNDABLE FEE PER ADULT TO BE USED TO OBTAIN A CREDIT REPORT.  I CERTIFY THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS CORRECT AND HEREBY AUTHORIZE DOUBLE A PROPERTIES TO VERIFY MY EMPLOYMENT, TO OBTAIN CREDIT REPORTS, AND TO CONTACT MY CURRENT AND PREVIOUS LANDLORDS.

APPLICANT’S SIGNATURE:

DATE:

PRIVACY POLICY ACT – EFFECTIVE SEPTEMBER 1, 2005

The privacy policy outlined bellowed applies to the Social Security data we collect from you.  This is our notice to you about hwy we collect your personal information; how we use it, how we share it and how we protect the information we collect and maintain.

How and why we collect your personal information:

1. I.    We ask that you provide us with your Social Security number at the time we initially take your rental/credit application.
2. II.    We need your Social Security number to verify information on the rental/credit application by all available means including but not limited to conducting employment and credit checks and verifying references.  We do not use the information for any other internal secondary purpose.
3. III.    If you do give us your personal information, we treat it very carefully.

How this personal information is protected:

1. I.    We will take reasonable precautions to maintain the security, confidentiality and integrity of the information we collect.
2. II.    Information in your file is confidential and is only assessable to Double A Properties.

How and when we will use your personal information:

1. I.    We do not sell the information we collect.
2. II.    The personal information you give us will be used only in connection with your rental/credit application and if applicable your lease agreement.

Who we will share your personal information with:

1. I.    We may disclose your Social Security number to your employer, previous and current landlords, credit companies and any other entities required to obtain and verify information submitted on the rental/credit application.

6. DEPOSIT AGREEMENT

I / We are interested in renting the home at ______________________.  I / We are providing a $_______ deposit which shall be returned only in the event that my / our application is not accepted.  Should my / our application be accepted, the deposit provided will become part of the required security deposit.

Providing false information in this application is grounds for rejection of this application of the termination of any lease signed in reliance upon the information contained in the application and the retention of any application fees as liquidated damages for Landlord’s expenses for processing this application.

APPLICANT’S SIGNATURE:

DATE:

LANDLORD’S SIGNATURE:

DATE:

FOR LANDLORD’S OFFICIAL USE ONLY

APPLICANT WAS NOTIFIED OF APPROVAL OR NON-APPROVAL ON:

NOTIFICATION WAS BY (PHONE, FAX, ETC.):

NAMES OF PERSON NOTICE WAS ACTUALLY GIVEN TO: