P.O.

Box 49712, Cookeville, TN 38506

RENTAL APPLICATION FORM

A Non-Refundable $50.00 application fee, per adult, must be paid before we can process your
application.
Also, you MUST provide a copy of your Drivers License with application or prior to move-in.
Submitting an application does not guarantee approval.
APPLICANT INFORMATION
Full Name:
Date of birth:
Current address:
City:
Landlord:
Landlord Contact #:
Previous address:
City:
Landlord:
Landlord Contact #:

SSN:

Phone:
Email:

Current employer:
Employer address:
Phone:
E-mail:
City:
Position:
Previous employer:
Address:
Phone:
E-mail:
City:
Position:
Name of a relative not residing with you:
Address:
City:
Relationship:

State:
Monthly payment or rent:
Reason for leaving:

ZIP Code:
Dates of residency:

State:
Monthly rent:
Reason for leaving:
EMPLOYMENT INFORMATION

ZIP Code:
Dates of residency:

State:
Hourly

Salary (Please circle)

State:
Hourly Salary

(Please circle)

How long?
Fax:
ZIP Code:
Annual income:
How long?
Fax:
ZIP Code:
Annual income:
Phone:
ZIP Code:

State:
CO-APPLICANT INFORMATION

Name:
Date of birth:
Current address:
City:
Landlord:
Landlord Contact #:

SSN:

Previous address:
City:
Landlord:
Landlord Contact #:
Current employer:
Employer address:
Phone:
City:
Position:
Previous employer:
Address:
Phone:
City:

Phone:
Email:

State:
Monthly rent:
Reason for leaving:

ZIP Code:
Dates of residency:

State:
Monthly rent:
Reason for leaving:
EMPLOYMENT INFORMATION

ZIP Code:
Dates of residency:

E-mail:
State:
Hourly

Salary (Please circle)

E-mail:

How long?
Fax:
ZIP Code:
Annual income:

Fax:
ZIP Code:

State:
1

P.O. Box 49712, Cookeville, TN 38506

RENTAL APPLICATION FORM

A Non-Refundable $50.00 application fee, per adult, must be paid before we can process your
application.
Also, you MUST provide a copy of your Drivers License with application or prior to move-in.
Submitting an application does not guarantee approval.

Position:
Hourly Salary (Please circle)
Annual income:
Name of a relative not residing with you:
Address:
Phone:
City:
State:
ZIP Code:
Relationship:
LIST ALL OTHER OCCUPANTS WHO WILL BE LIVING IN HOUSEHOLD
Name:
Relation:
Birthdate:
Name:
Relation:
Birthdate:
Name:
Relation:
Birthdate:
APPLICATION INFORMATION
Do you or anyone listed smoke?
Do you have any pets?
Have you or anyone listed been
If yes, explain:
evicted?
Have you ever fi led for bankruptcy?
If yes, what chapter?
Date discharged?
Have you or anyone listed been
If yes, explain:
convicted of a felony?
VEHICLES INFORMATION
Vehicle Make/Model:
Year:
Tag ID:
Exp. Date:
Vehicle Make/Model:
Year:
Tag ID:
Exp. Date:
PERSONAL REFERENCES
LIST NON-RELATIVE REFERENCES, INCLUDING YOUR RELATIONSHIP & PHONE NUMBER
Reference #1:
Reference #2:
Reference #3:
Reference #4:
CREDIT CARDS
Name
Account no.
Current balance
Monthly payment

Auto loans

AUTO LOANS
Account no.
Balance

Description

OTHER LOANS, DEBTS, OR OBLIGATIONS

Account no.
Amount

Description

OTHER ASSETS OR SOURCES OF INCOME

Amount per month or value

Monthly payment

I/We declare that the statements provided in this application are true and correct to the best of my knowledge and
I/We hereby give authorization to A.D. Ventures to release information for verifi cation of all statements given on
this application.

P.O. Box 49712, Cookeville, TN 38506

RENTAL APPLICATION FORM

A Non-Refundable $50.00 application fee, per adult, must be paid before we can process your
application.
Also, you MUST provide a copy of your Drivers License with application or prior to move-in.
Submitting an application does not guarantee approval.

Signature of applicant

Date

Signature of co-applicant

Date