Bitter Creek Leasing

Personal Information

Full Name First, Middle, and Last Name

Maiden Name If applicable

Phone Your input is very valuable.

Social Security Number Ex. xxx-xx-xxxx

Date of Birth

Driver's License Number Include State initials if not in Oklahoma.

Current Address

How long? Ex. 3 years

Street Address Ex. 123 Main Street (Apt#)

City

State

Previous Address

How long? Ex. 3 years

Street Address 123 Main Street (Apt. #).

City

Previous address state

Relative Information

Relative Name

Address

City

State

Parents Name

Parents Address

City

Parents state

Rental History

Current Landlord Name or Company

Phone numbers only.

Prior Landlord Name or Company

Phone

How many will be living in this unit?

Adults 18 or older

Children Under 18 years of age.

Pets Dogs and/or Cats.

Pet Weight Combined weight.

Employment Information

Employer

Occupation

Current Monthly Salary

How Long? Ex. 5 years.

Contact Person Full Name that can verify employment

Employer Phone

Spouse Information

Spouse Name Full Middle and Last.

Phone Ex xxx-xxx-xxxx.

Spouse Social Ex. xxx-xx-xxxx.

Spouse Driver's License Include State initials if not in Oklahoma.

Spouse Employer

Spouse occupation

Current Monthly Salary

How Long? Ex. 5 years.

Contact Person To Verify Employment.

Employer Phone

Bank Information

Bank Name

Bank Phone

Bank Address

Bank City

Bank State

Check Account Number

Savings Account Number

Personal References

Name

Relationship

Phone Number

Name

Relationship

Phone Number

Name

Relationship

Phone Number

Credit References

Credit Grantor

Creditor Address

Phone

Credit Grantor

Creditor Address

Phone

Credit Grantor

Creditor Address

Phone

Other Information

Number of Vehicles (including company cars):

Vehicle Make

Vehicle year

Vehicle color

Vehicle tag number

Vehicle Registration State

Vehicle make

Vehicle year

Vehicle color

Vehicle tag

Vehicle Registration State

If you have more than 2 vehicles, please list them in the details section below.

Have you ever:

Filed for Bankruptcy?

Yes

Been served an eviction notice or been asked to vacate a property you were renting?

Yes

Willfully or intentionally refused to pay rent when due?

Yes

Been sued for unlawful detainer?

Yes

If you answered yes to any of the above or have additional information to include, please include it here:

How were you referred to us?

Rental Information

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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