V.M.

Olnc 48 Grove st, Littleton NH 03561

RENTAL APP]UCAnON
Today's Date
Propertyad~s Monthly rent Applicant .-t..Date f anncipared reove in o _ Pet deposit _

Security deposit

Full~ofapplicffitt

~
(wOlk) _----_

~emAd&~s-Telephone number (borne) D.O.B.

Applicant's emplo~"lIlent

_
social security # Driver's license _

Nameofpres~emproyer Adm~s
Position

~ __ . Date started _ _
. _ ___
_ phone

_
~_Monthlyi1lcome
phone ~_-

Supervisor's name Name of previous employer,

Ad~s

Position
Supervisor's name Other soun::es ofiocome Spouse Full name of spouse PresemAdd~s

Date started

Monthly income -----------------

_
_

_ _

Telephone number (home) D.O.8. Spouse's employment Name of present employer

, social security #

(work)

Driver's license

A~s

_
Date started

.
_____ ,
phone

~-Monthly income _
_

Position Supervisor's name Narneofpren~e.rnploy~_

Address

_
_

. ~ --Date started Monthly income

Position

Supervisor's name

--

--

phone ~

~rsowr~of~nre
Present Landlord. or mortgage

--------------------------------------------company
_

Present Landlord or mortgagewmpany

Telephone number (home) _________________________ Monthly rent or mortgage paynent ---'-.Date of move-in

(worlq

-------------Date of move-out

Previous LandlOrd or mortgage company

Previous Landlonformortgagecompany Telephone number (home) Monthly rent or-mortgage payment --Personal References phore _ pbore _ .. worlt) { Date of move-m Date of move-out _ _ _

Nrume

Ad&ress

Nrume
Address

Emergency
fu~eofemergemycOnffict Relationship Occupants Lffitalloccupants Pets List any pets: type List any pets: type Vehicles tffit vehicles to be parked at premises: make make model model year year phone _

----+------------------_.
_

breed breed

weigbt weight

age age

_ _

Credit/Criminal History Bank name Address Ch~kIDgaccoumnumber

List all credit obligations with minimum monthly payment:

phone

_ _ _

Have any of the occupants listed above ever been: convicted of a felony? received defetred adjudication for a felony? been evicted? broken a lease? declared bankruptcy? _ The above listed applicant declares that:all statements made in this application are true and complete. Applicant hereby authorizes the National Association of Independent LandlOlds to verify an of tIJe infonnation in this application and obtain credit reports on the above listed applicant andtor applicant's. If applicant or applicant's spouse has given any false information Landlord is entitled to reject the application,. and retain all application fees as liquidated damages for Landlord's time and expenses in processing this application. Applicant shall give Landlord a nonrefundable application fee in the amount of $

Signature of applicant Signature of Spouse Signature of Landlord or Landlord's agent

Date Date

__________________________ Dme ---------------