Rental Application

Back to      PLU Rental House      Home 

Name ____________________________    For (address)     ______________________

Home                                                               Work                                                              

Phone  ___________________________      Phone ______________________________

Social                                       Driver’s                                               Date of

Sec. No. _______________      License No __________________            Birth _____________

Present Address  __________________________________________________________

            How long at                                                  Reason for

            This address? ___________            Rent $_____            moving _______________________

            Owner/ Manager ___________________________________________________

Previous Address  ________________________________________________________

            How long at                                                  Reason for

            This address? ___________            Rent $_____            moving _______________________

            Owner/ Manager ___________________________________________________

Personal References (especially if you have not rented before):

Name ________________            Address ____________________            Phone ____________

Name ________________            Address ____________________            Phone ____________

Any pets? ________            Describe ______________________________________________

Present Occupation _______________________________________________________

If student, Major _________________________________________________________

Vehicle(s)

Make(s) __________            Model(s) _________            Year(s) _______  License(s) ____________

Contact in

Emergency ___________________            Address ___________________  Phone _________

I declare that the statements above are true and correct.  I authorize verification of my references as they relate to my tenancy and to future rent collections.

Date ____________            Signed _______________________________________________

Pat Logen  29104 88^th Ave NW Stanwood WA 98292 (360) 629-4306 or (425) 238-6684