NON-BYU RENTAL APPLICATION

All sections are required:

    Last Name First Name Middle Name Soc. Sec. #
    Date of Birth Driver's Lic. # State Home Phone #
    Present Address City State Zipcode
    Date In Date Out Owner/Mgr. Name Owner/Mgr. Phone
    Reason for Moving
    Previous Address City State Zipcode
    Date In Date Out Owner/Mgr. Name Owner/Mgr. Phone
    Reason for Moving
    Next Previous Address City State Zipcode
    Date In Date Out Owner/Mgr. Name Owner/Mgr. Phone
    Reason for Moving
    Proposed Occupants (List all in addition to yourself)
    Name Age Name Age
    Name Age Name Age
    Name Age Name Age
    Name Age Name Age
    Will you have pets? YesNo Describe
    Will you have liquid filled furniture? YesNo Describe
    Present Occupation Employer Name
    How long with this employer? Employer Address
    Name of Supervisor Employer Ph. #
    Prior Occupation Employer Name
    How long with this employer? Employer Address
    Name of Supervisor Employer Ph. #
    Current Gross Income? Per WeekMonthYear
    Please list ALL of your financial obligations below.
    Name of Creditor Address Phone Number Mon. Pymt. Amt.
    In Case of Emergency Notify
    Contact Name* Relationship*
    Address City State Phone
    Contact 2 Name Relationship
    Address City State Phone
    Personal References
    Reference Name Length of Acquaintance
    Occupation Address Phone
    2nd Reference Name Length of Acquaintance
    Occupation Address Phone
    Automobiles
    Make Model Year Lic. Plt. #
    Make Model Year Lic. Plt. #
    Motorcycles (Other Vehicles)
    Have you ever filed for bankruptcy? YesNo
    Do you smoke? YesNo
    Have you ever been evicted or asked to move? YesNo
    Have you ever served in the military? YesNo
    Have you ever been arrested? YesNo
    If yes, please explain:
    APPLICANT REPRESENTS THAT ALL THE ABOVE STATEMENTS ARE TRUE AND CORRECT AND HEREBY AUTHORIZES VERIFICATION OF THE ABOVE ITEMS INCLUDING BUT NOT LIMITED TO THE OBTAINING OF A CREDIT REPORT AND AGREES TO FURNISH ADDITIONAL CREDIT REFERENCES ON REQUEST.
    THE UNDERSIGNED MAKES APPLICATION TO RENT HOUSING ACCOMMODATION DESIGNATED AS:
    Apt. No Located At
    The rental for which is $ Per
    I understand that this is a routine application to establish credit, character, employment and rental history. I also understand that this is NOT an agreement to rent and that all applications must be approved. I authorize verification of references given. I declare that the statements above are true and correct, and I agree that the landlord may terminate my agreement entered into in reliance on any misstatement made above.
    Please attach a drivers License or Photo ID:
    Dated:
    Office Address:
    334 East Center St.
    Provo, UT 84606
    Phone (801) 607-1680
    Fax (801) 377-4343
    Applications are accepted after hours via fax or in the drop box.

    How did you hear about us?
    Desired move-in date: Email Address