Please print and fill out application and fax or return it to our office.
Standard Application
Don Johnson Real Estate LLC
303 Broadway, Chesterton, IN 46304
Office: (219) 926-2178 Fax (219) 926-5149
PLEASE INCLUDE PROOF OF INCOME AND COPY OF YOUR ID WITH THIS APPLICATION.
ADDRESS APPLYING FOR: ______________________________________________________________________________
APPLICANT #1: PRINT CLEARLY
Name: ________________________________________ Phone#: ___________________ DOB: ____________
Soc Sec#: _______________________________________ Drivers License#: ___________________________
ST ___________ Exp: _______ E-MAIL: _____________________________________________________
Current Address: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Current Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
Current employer: _____________________________________ Position _____________________
Phone: ______________________ Monthly Income: ________________ How Long: __________
Employers Address: __________________________________________________________________
Name: ________________________________________ Phone#: ___________________ DOB: ____________
Soc Sec#: _______________________________________ Drivers License#: ___________________________
ST ___________ Exp: _______ E-MAIL: _____________________________________________________
Current Address: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Current Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
Current employer: _____________________________________ Position _____________________
Phone: ______________________ Monthly Income: ________________ How Long: __________
Employers Address: __________________________________________________________________
GENERAL INFORMATION:
Number and Type of Pets: ___________________________________________________________
Name of Bank: ______________________________ Branch _________________ Acct. Type ___________
Name of Bank: ______________________________ Branch _________________ Acct. Type ___________
Personal References:
Name ____________________________ Yrs known:___ Relationship _________ Phone ______________
Name ____________________________ Yrs known:___ Relationship _________ Phone ______________
Name ____________________________ Yrs known:___ Relationship _________ Phone ______________
Names/Relationship of all occupants (other than yourself) ___________________________________
____________________________________________________________________________
____________________________________________________________________________
PREVIOUS ADDRESS FOR THE PAST 5 YEARS:
Address #1: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
Address #2: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
Address #3: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
Address #4: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
Address #5: ___________________________________________________________________
City: ______________________ ST: __________ ZIP: ___________
Landlords Name: _______________________________ Phone#: ___________________
How Long at this address: _________ Reason for leaving: _______________________________
I CERTIFY all answers given herein are true and complete to the best of my knowledge. I authorize an investigation of all statements contained in this application for the resident screening as may be necessary in arriving at a resident decision. I authorize the landlord, owners, and/or their agents to perform a credit and criminal background check. I understand that the landlord may terminate any rental agreement entered into for any misrepresentation made above.
Signature: ____________________________________ Date:_____________________
Signature: ____________________________________ Date:_____________________ |
