Rental Application cont

Credit Name__ Name_

Bank Bank Name _ Checking acct.

References Bank Name ___ Savings acct. #

References Address _

Address _

Address___

Emergency (Please list relative or friend, not spouse or children)

I hereby deposit with owner/agent, the sum of $_as_partial_full security deposit on the above premises pending execution of a lease agreement. I understand that my deposit may be applied toward any rent loss, advertising costs, re-rental fees, etc. if this application is approved and I am unable to fulfill the conditions of occupancy. The deposit will be returned if this application is not approved, providing all the above questions are answered truthfully and correctly.

I have been shown a copy of the lease agreement and agree to the conditions of occupancy that are enumerated therein, and find no conflict with the Ohio Revised code and will adhere to the agreements if my application is approved based on the information contained herein.

I hereby grant permission to the owner/agent to verify through Federal Adjustment Bureau, Inc. the validity of all the above statements to be true and correct. I understand that this application does not constitute any oral and/or written commitments on the part of the owner/ agent.

A payment of $_is included herewith, which payment is made for the purpose of verifying the information included on this application. I understand this charge is not, under any circumstances, to be returned to me.

Applicant Date

Applicant Date

Application Taken By__ Date_Amount Rec'd $_

Security Deposit___ Balance Due___

Rental Application Q Approved Q Rejected Date Applicant Notified_

What personal skills do you have? Q Painting Q Electrical Q Plumbing Q Roofing

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