Home Realty Company Rental Application

Office phone 256-831-6692 / Fax 256-831-6694

Property Address: __________________________________________

Primary Tenant:

Name: __________________________________________ D.O.B.: ______________

SS#: _________________________Current home phone #: ___________________

Current Address: (Street)_____________________________________________________

(City)____________________ (State)_____ (Zip)__________________

How long there? ____________________ Rent or Own? ______________________

Landlord’s Name & Phone #: _______________________________________________

Previous Address: (Street)____________________________________________________

(City)_______________________ (State)_____ (Zip)________________

How long there? _____________________ Rent or Own? ________________________

Landlord’s Name & Phone #: _______________________________________________

Current Employer: ________________________ Work phone #: ________________

Name of Supervisor: ______________________ How long there? _______________

Income ____________________________________

Spouse or Roommate:

Name: __________________________________________ D.O.B.: ________________

SS#: __________________________ Current home phone #: _____________________

Current Employer: ________________________ Work phone #: _________________

Name of Supervisor: _______________________ How long there? _______________

Income _____________________________________

Current Address: (Street)_____________________________________________________

(City)_______________________ (State)_______ (Zip)______________

How long there? _____________________ Rent or Own? __________________

Landlord’s Name & Phone #: _______________________________________________

Monthly Gross Income:  ___________________________________________________

Additional Information:

Number of Adults and Children to live in Property: ___Adults ___Children

Do you own a pet? Yes or No Describe: _____________________________________

In the event of an Emergency, notify: (Name)___________________________________

(Phone)____________________ (Address)___________________________________________

Nearest Relative: (Name)_________________________________ (Phone)______________

Personal References:

Name Address Daytime Phone #

1. ___________________________________________________________________________

2. ___________________________________________________________________________

3. ___________________________________________________________________________

4. ___________________________________________________________________________

I/We certify that the above information is accurate and we understand that Home Realty Company will verify the information. I/We hereby give our consent to have Home Realty Company or any credit bureau which it may designate, to obtain any and all information concerning our employment, obligations, and all other credit matters which they may require, in connection with our rental application. I/We also authorize the release of the aforementioned information by the employer, credit bureau, financial institution, government agencies, and all other grantors of credit as listed on our rental application. This form may be reproduced or photocopied and the copy shall be as effective as the original letter, which we have executed on the undersigned date.

I understand that I am to pay an application fee to Home Realty Company and I further understand that this fee is non-refundable. 

Your application cannot be process without the application fee being paid.

_______________________________________ _______________________

Primary Tenant                                                                                        Date

_______________________________________ _______________________

Spouse or Roommate                                                                             Date

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