Bitter Creek Leasing - Online Rental Application
Date 12/10/2024 8:22:27 PM
Personal Information
Your Full Name:
Your Maiden Name:
Telephone:
Social Sec. No:
Date of Birth:
Driver's License No:
Present Address:
City:
State:
Select One...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Dakota
North Carolina
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Outside the USA
Prior Address:
City:
State:
Select One...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Dakota
North Carolina
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Outside the USA
How long have you lived at present address?
Select One...
Months
Years
How long have you lived at prior address?
Select One...
Months
Years
Nearest Relative (NOT living with you):
Nearest Relative Address:
Nearest Relative City:
State:
Select One...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Dakota
North Carolina
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Outside the USA
Parents Name:
Parents Address:
Parents City:
State:
Select One...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Dakota
North Carolina
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Outside the USA
Name of Landlord:
Telephone:
Prior Landlord:
Telephone:
How many will be living in this unit?
Adults:
Children:
Pets:
Weight of Pets:
Employer:
Occupation:
Current Monthly Salary:
How long?
Contact Person:
Employer Telephone:
Spouse Information
Name of Spouse:
Telephone:
Social Sec. No:
Driver's License No:
Employer:
Occupation:
Current Monthly Salary:
How long?
Contact Person:
Employer Telephone:
Bank Information
Bank Name:
Bank Telephone:
Bank Address:
City:
State:
Select One...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Dakota
North Carolina
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Outside the USA
Checking Account No:
Savings Account No:
Personal References
Name:
Relationship
Telephone:
Credit References
Credit Grantor:
Address
Telephone:
Other Information
Number of Vehicles (including company cars):
Make/Model
Year
Color
Tag No.
State
Have you ever:
Yes
No
Filed for Bankruptcy?
Yes
No
Been served an eviction notice or been asked to vacate a property you were renting?
Yes
No
Willfully or intentionally refused to pay rent when due?
Yes
No
Been sued for unlawful detainer?
If you answered yes to any of the above, please explain:
How were you referred to us?
Rental Unit applied for:
Commencement Date:
Term:
Rent/Month:
I understand that Bitter Creek Leasing is a leasing agent for the owners of the applied property. I do hereby authorize Bitter Creek Leasing to investigate my qualifications, and release in any manner, any and all of the information obtained. I do hereby authorize any and all persons, agencies, or firms from any liability resulting from providing such information.
I do hereby declare under penalty of perjury that the information that I have listed above it true and correct. I also understand and false or incorrect information is grounds for rejection of this application. I further understand that failure to property and fully fill in all information slots will result in the application not being considered for lease status.
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