Rental/Credit Application

So, you’ve decided to take the next step and apply to one of our properties. Great! Please take a moment to fill out the fields below. When you’re done, check the box at the bottom certifying that you agree to our terms, click the ‘Submit’ button, and you’re done! We’ll review your application and let you know when we make a decision.

Personal Information:

Name of Applicant: *

E-mail: *

Phone Number: *

Date of Birth: *

Social Security No:

Driver's License No.:

Present Address: *

Years at present address: *

Landlord's Name: *

Landlord's Phone: *

Prior Address: *

Years at prior address: *

Prior Landlord's Name: *

Prior Landlord's Phone: *

Desired Property: *

Adults: *

Children: *

Pets: *

Describe any pets:

Employer: *

Occupation: *

Current Salary: *

Years at current job: *

Employment Contact: *

Contact Telephone: *

Spouse Information:

Spouse Name:

Telephone:

Social Security No.:

Employer

Current Salary

Years at current job

Employment Contact

Contact Telephone

Bank Information:

Bank Name:

Bank Telephone:

Checking Account #:

Savings Account #:

Personal/Credit Reference:

Reference Name:

Relationship:

Phone:

Other Information:

Number of Vehicles: *

Please list the color, make and model for all vehicles below:

Vehicle(s) Information: *

Have you ever...

Filed for Bankruptcy? *

Yes

Been served an eviction notice? *

Yes

Refused to pay rent when due? *

Yes

Been sued for unlawful detainer? *

Yes

If Yes, Please Explain:

Consent:

I authorize Breckenridge Rental Homes to investigate my credit qualifications and hereby release, in any manner, all of the information obtained by you. I further release all persons, agencies, or firms from any liabilities resulting from providing such information.

I declare under penalty of perjury that the information listed in this
application is true and correct.

I agree to the above statement: *