Address you are applying for:
(Leave blank if unknown)
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Date of desired occupancy:
(MM/DD/YYYY)
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 (Please click on the calendar icon to select the date)
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Is your credit:
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| Your Personal Information |
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Joint Occupancy?
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Yes No
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If Yes, Name applying with:
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* First Name:
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Middle Name:
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* Last Name:
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Date of Birth:
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(Please click on the calendar icon to select the date)
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Social Security Number:
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Drivers license number and state:
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Drivers license state:
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Current home address:
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City:
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State:
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Zip Code:
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Phone Number:
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E-mail Address:
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How long at current residence:
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Names and Types of Pet(s):
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| List 10 Years of Residence History or at least your last 2 Addresses |
| Current Landlord OR Mortgage Company |
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If renting, Management Company Name OR Mortgage Company:
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Address you lived at:
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Landlord or Contact Name:
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Landlord or Contact Phone Number:
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Current Monthly Rental Amount:
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Were You Ever Late?
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Yes No
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Were You Evicted?
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Yes No
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Have you ever filed Bankruptcy:
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Yes No
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If Yes, What Type:
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Discharged Date:
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Have you ever had a Short Sale of Deed In Lieu of Foreclosure:
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Yes No
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Date of Short Sale or Deed in Lieu:
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(Please click on the calendar icon to select the date)
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Have you ever had a foreclosure:
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Yes No
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Date of Foreclosure:
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(Please click on the calendar icon to select the date)
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| Previous Landlord - A |
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If Renting, Management Company Name:
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Landlord or contact Name:
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Landlord or contact phone:
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Monthly Rent Amount:
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| Previous Landlord - B |
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If Renting, Management Company Name:
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Landlord or contact Name:
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Landlord or contact phone:
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Monthly Rent Amount:
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| Previous Landlord - C |
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If Renting, Management Company Name:
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Landlord or contact name:
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Landlord or contact phone:
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Monthly rent amount:
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| Your Work History |
| Please give at least 4 year work history. If not enough space please add under comments |
| Current Employer |
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Present Employer:
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Supervisors Name:
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Supervisors Number:
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Current Position:
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Your Gross MONTHLY Income:
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Date you began this job:
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(Please click on the calendar icon to select the date)
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What are your pay days?
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| Current/Previous Employer |
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Employer Name:
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Supervisors Name:
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Supervisors Number:
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Current Position:
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Dates you began/ended this job:
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Your Gross MONTHLY Income:
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| Current/Previous Employer |
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Employer Name:
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Supervisors Name:
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Supervisors Number:
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Current Position:
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Dates you began/ended this job:
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Your Gross MONTHLY Income:
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| Other Income |
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Other Monthly Income Received:
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Source of other income:
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Current/Previous Employer:
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Employer Number:
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Your Gross MONTHLY Income:
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Dates you began/ended this job:
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Do you have a checking account?
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Yes No
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Name of Bank:
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List your major monthly expenses car payments, credit cards, medical bills, child support, insurance, etc...
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| Emergency Contact |
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Name:
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Address:
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Phone Number:
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Email:
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Relationship:
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| Personal Skills |
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Plumbing
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Carpentry
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Painting
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Electrical
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Other
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| Tools You Own |
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Toolbox
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Mower
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Yard Tools
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Snow Shovel
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Hoses/Sprinklers
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Vacuum
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| Vehicles |
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List all vehicles that will be parked at the property. Make/Model/Year
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| Please answer the following questions (explain your answers as necessary) |
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Have you ever been evicted or asked to move from any tenancy?
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Have you ever broken a rental agreement or lease?
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Have you ever willfully and intentionally refused to pay rent when due?
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Do you know of anything that might interrupt your income or ability to pay rent?
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Are there any outstanding judgments against you?
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Have you had property foreclosed upon or given title or deed in lieu of foreclosure in the past 7 years?
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Have you ever filed a petition of bankruptcy? (if yes, please note when and where, if the bankruptcy has been discharged and date of discharge.)
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Are you a named party to a criminal proceeding, lawsuit, or unlawful detainer filing?
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Have you ever initiated or been the defendant in a lawsuit?
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Have you or anyone in your household ever been convicted of a felony or misdemeanor?
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Rent is due in advance on the last business day of each month. Are you able to fulfill this requirement?
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Are you the co-maker or endorser on any lease, loan, or mortgage?
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Do you plan to conduct any commercial business from the residence?
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How many smokers in your household?
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Reason for moving?
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Type any comments or special requests you may have below:
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| Applicant understands that any false statements or deliberate misrepresentation of facts will automatically disqualify this application and cause any subsequent rental contract to be null and void and of no effect. |
| AUTHORIZATION: By typing in your complete name: I do hereby authorize a review and full disclosure of all records, or any part thereof, concerning myself by/to NoCo Rent To Own, LLC or Jonathan Blake Stevens. The intention of this authorization is to provide information which will be utilized in connection with a rental application, current lease, former lease, lease renewal and/or collection of funds due NoCoRentToOwn, LLC and/or assigns. |
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Electronic Signature of Applicant
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Date of application:
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(Please click on the calendar icon to select the date)
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| If written authorization is required for your landlord or employer you may be asked to copy and paste the following and faxing it back to us at 970-225-6626 |
| I hereby authorize current and past landlords, current and past employers, financial institutions, personal references, Courts of law and any other person/entity to release information regarding my rental, employment, credit and/or criminal history. I agree to indemnify and hold harmless the person to whom this request is presented and his agents and employees from and against all claims, damages, losses and expenses, including reasonable attorneys fees arising out of or by reason of complying with this request. This authorization shall survive the original application process and be valid during or subsequent to any lease term. A copy of this authorization may be accepted as an original. |
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