Rental Application Mail to or drop off at:

Fax to: (607) 722-6650 D3VON, LLC

Phone: (607) 651-6833 7 S. Washington St.

Binghamton NY 13903

Separate application required from each adult applicant (age 18 or older). All adults living at the rental must sign the lease.

Address of Property to Be Rented: ________________________ Term: from ________ to ________

Amounts Due Prior to Occupancy

First month's rent                                              $____________________

Security deposit (equal to 1 months rent)         $____________________

Other (e.g., extra months rent security deposit for pets): $____________________

Applicant Full Name (print clearly!!): ______________________ Phone: (____)_____________

Car Make/Model: _________________ Color: _______ Year: _______

Additional Occupants  Full Names, relationship to Applicant: ___________________________

_______________________________________________________________________________

Rental History CURRENT Address: ________________ Term: _____________________

City, State, ZIP:_____________________ Reason for Leaving: ______________

Landlord/Manager: __________________ Landlord's Phone: (____)__________

Previous Address Street Address: _____________________ Term: ____________________

City, State, ZIP:_____________________ Reason for Leaving: ______________

Landlord/Manager: __________________ Landlord's Phone: (____)__________

Employment History

Current Employer Name, Address (street, city, state): ___________________________________

Name of Supervisor: ____________________

Dates Employed at This Job: ____________________ Position or Title: ___________________

 ------------------------

Previous Employer Name, Address (street, city, state): __________________________________

Name of Supervisor: ____________________

Dates Employed at This Job: ____________________ Position or Title: ___________________

Income & Obligations

1. Your gross monthly employment income (before deductions):         $ ________

2. Average monthly amounts of other income (specify sources):          $ ________

Major Obligation(s): Creditor __________________ Amount Owed ______ Monthly Payment _______

Creditor __________________ Amount Owed ______ Monthly Payment _______

Miscellaneous

Describe the number and type of pets you want to have in the rental property: ____________________________________________

Describe water-filled furniture you want to have in the rental property: __________________________________________________

Do you smoke? [   ] yes [   ] no

Have you ever:

Filed for bankruptcy? [   ] yes [   ] no

Been sued? [   ] yes [   ] no

Been evicted? [   ] yes [   ] no

Been convicted of a crime? [   ] yes [   ] no

 

Explain any yes listed above: ________________________________________________________________________________

I certify that all the information given above is true and correct and understand that my lease or rental agreement may be terminated if I have made any false or incomplete statement in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers and personal references.

 

Date _______________          Applicant signature __________________________________

(authorization to check references)

 

Consent to Contact References and Perform Credit Check

I authorize Devon McBride (the landlord) to obtain information about me from my credit sources, current and previous landlords, employers, and personal references to enable him to evaluate my rental application. I give permission for the landlord or its agent to obtain a consumer report about me for the purpose of this application, to ensure that I continue to meet the terms of the tenancy, for the collection and recovery of any financial obligations relating to my tenancy, or for any other permissible purpose.

 

(The Consumer Credit Report is obtained from Experian at a cost of $9.95, paid by applicant. Make check payable to D3VON, LLC, or fill out credit card authorization form and submit with application.)

 

 _______________________________ _________________
Applicant signature (authorization to check credit) Date

_______________________________ _________________________________
Social Security Number Billing address (if different from current address)