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RENTAL APPLICATION (Part 1 of 2)

Authorization is hereby granted to DR Investment Properties and/or Radiant New Horizon Homes LLC/Exit New England Realty Advisors to conduct a background investigation concerning my credit history, criminal background, eviction history, public records search, employment, and any other inquiry through public or private sources to determine my suitability for rental of the property address being applied for.

By submitting this form I, the Applicant, authorize any person or credit checking agency having any information on him/her to release any/all such information to the Owner / Landlord / Sub-Landlord / Property Manager / Employees / Rental Agent or credit checking agencies. Authorization is further granted to the reporting agency to use a photostatic reproduction of this authorization if necessary to obtain any information regarding the above mentioned information.

Applicant hereby releases, remises and forever discharges, from any action whatsoever, in law and equity, all owners, landlords, sub-landlords, property managers, employees, rental agents and their credit checking companies in connection with processing, investigating or credit checking this application, and will hold them harmless from any suit or reprisal whatsoever.

Any reproduction of this credit report authorization and release made by reliable means (for example, photocopy or facsimile) is considered original.

NOTE: Please submit an application for each person 18 years or older that would be financially responsible for the rental of this property (including any co-signer(s)).

APPLICANT INFORMATION

* = required information

* Address Applied For:

* First Name :

Middle Name (or initial) :

* Last Name :

Maiden Name or Other Aliases :

* Date Of Birth (mm/dd/yyyy) :

* Social Security Number (###-##-####) :

Driver's License Number :

Driver's License State :

* Phone (###-###-####) : Invalid format.

Alternate Phone (###-###-####) : Invalid format.

* E-mail Address :

RESIDENCE HISTORY

Current Residence

* Street Address :

* City :

* State :

* Zip Code :

How long have you been at this address ?

* From (mm/yy) :

* To (mm/yy) :

Own or Rent ? Own Rent N/A

* Current Monthly Rent or Mortgage Payment :

If renting, Landlord's Name :

Landlord's Phone Number : Invalid format.

Is your current lease complete ? Yes No N/A

If current lease not complete, when does it expire ?

* Why do you wish to move from your current address ?

Previous Residence

Street Address :

City :

State :

Zip Code :

How long at previous address :

From (mm/yy) :

To (mm/yy) :

Own or Rent ? Own Rent N/A

Previous Monthly Rent or Mortgage Payment :

If rented, Landlord's Name :

Landlord's Phone Number : Invalid format.

Reason for leaving :

Prior Residence

Street Address :

City :

State :

Zip Code :

How long at prior address :

From (mm/yy) :

To (mm/yy) :

Own or Rent ? Own Rent N/A

Prior Monthly Rent or Mortgage Payment :

If rented, Landlord's Name :

Landlord's Phone Number : Invalid format.

Reason for leaving :

EMPLOYMENT HISTORY

Current Employment

Employer :

Street Address :

City :

State :

Zip Code :

Phone Number : Invalid format.

Your Position/Job Title :

Name of Supervisor :

How Long at Current Employer :

From (mm/yy) :

To (mm/yy) :

Gross Monthly Income :

Previous Employment (or 2nd job, if applicable)

Employer :

Street Address :

City :

State :

Zip Code :

Phone Number : Invalid format.

Your Position/Job Title :

Name of Supervisor :

How Long at Previous Employer :

From (mm/yy) :

To (mm/yy) :

Gross Monthly Income :

Prior Employment (or 3rd job, if applicable)

Employer :

Street Address :

City :

State :

Zip Code :

Phone Number : Invalid format.

Your Position/Job Title :

Name of Supervisor :

How Long at Prior Employer :

From (mm/yy) :

To (mm/yy) :

Gross Monthly Income :

ADDITIONAL SOURCES OF INCOME

	Source	Monthly Income
1.
2.
3.
4.

Any further additional monthly income ? Yes No

If yes, please list source(s) and amount(s:

BANKING AND CREDIT HISTORY

Do you have a checking account ? No Yes

If yes, bank/institution name :

Do you have a savings account ? No Yes

If yes, bank/institution name :

Credit cards or other ? No Yes

If yes, details :

* Have you ever had your wages garnished ? No Yes

* Have you ever declared bankruptcy ? No Yes

* Have you had 2 or more late rental payments in the past year ? No Yes

* Have you ever been evicted ? No Yes

*** If answered yes to any of the above, please list dates and details :

PERSONAL REFERENCES

	Name	Address	Phone
1.
2.
3.

List any additional references you would like to provide :

OTHER PROPOSED OCCUPANTS

List full names and ages of all children under 18 who would be residing with you :

All Other Proposed Occupants
	Name	Birthdate	Relationship to Applicant
1.
2.
3.
4.

* Do you have any pets and/or service animals ? Yes No

If yes, what kind(s), what breed(s) and how many ? Also indicate which are service animal(s), if any.

VEHICLES

(Include vehicles belonging to other proposed occupants)
	Make/Model	Color	Year	License Plate
1.
2.
3.
4.

ADDITIONAL INFORMATION

* Do you have a waterbed ? Yes No

* Do you have someone to co-sign the contracts ? Yes No N/A

* Where Did You Hear About Us ?

Additional Comments :
(Please give us any additional information that might help us to evaluate your application.)

I, Applicant, do hereby represent that all the information in this Rental Application is true and accurate and that the Owner / Landlord / Sub-Landlord / Property Manager / Employees / Rental Agent may rely on this information when investigating and accepting my rental application. Applicant hereby authorizes Owner / Landlord / Sub-Landlord / Property Manager / Employees / Rental Agent to make an independent investigation to determine my credit, financial, and character standing.

I hereby understand that the credit, rental history, arrest/conviction and other reports will be done through the facilities of Tenant Tracks (the tenant screening service we use) and costs $27.00 per applicant of age 18 years or older, payable by credit or debit card only. If you do not have a credit or debit card, it is possible to purchase a prepaid debit card. This website is protected with SSL security to protect against hackers. All info is secure.

Please enter credit or debit card information below:

* Credit or Debit Card # :

(####-####-####-####)

(or ####-######-##### if American Express)

* Expiration Date (mm/yy) :

* Validation Code :

(### on back of card or #### on front of card if American Express)

(After submitting this application, we will need income verification. Part 2 is information on acceptable proof of income and instructions on how to submit that. Without proof of income, we would not run a tenant screening report, you would not be charged anything and your application would not be considered.)