Monthly Winter Rental Application

Rental Properties you are applying for (in order of preference)
1st Choice: Rent:$
2nd Choice: Rent:$
3rd Choice: Rent:$



Lease Dates Preferred:
(Enter dates as mm/dd/yyyy)
From:
To :

Full Name :
Soc.Sec.#:
Work # :
Home # :



Spouse's Name:
Spouse's SS#:
Spouse's Work#:


Present Address:
How long at Present Address:    Monthly Rent: $
Present Landlord:
Address:   Phone #:
Notes:
Number of Persons to occupy property: (Give names, ages, relationship)
a.     b.
c.     d.

Pets:How many?
What type of pet(s)? (Please be specific)

Name of Employer: Employer's Phone#:
How long: Position Held:
Annual Income: Other Income:

Spouse's Employer: Employer's Phone#:
How long: Position Held:
Annual Income: Other Income:

Automobiles:Make: Year: License#/State:
Make: Year: License#/State:

In case of emergency:
Person to notify
Relationship:
Address:
Phone#:
Your E-Mail address:

  1. This application shall not be construed as a lease agreement.
  2. This application is made subject to Owner's approval and may be dissapproved without designating cause.
  3. It is understood if this application is approved, the deposit made will be held as security for the performance of all terms and conditions of the Lease Agreement by the applicant. However, if this application is approved by the Owner and the applicant does not enter into a Lease Agreement, the deposit made shall not be refunded. In the event this application is not approved, the deposit will be returned to the applicant and both parties shall have no further liability to each other.
  4. All questions must be answered in order for application to be considered.
  5. Applicant(s) authorize the REALTOR to verify the foregoing information and to make credit and reference inquiries deemed necessary by them. Applicant(s) also authorize the release of information contained on this application or sought by such inquiries.
  6. An APPLICATON FEE OF $40.00 (non-refundable) must be paid by check or money order made payable to Siebert Realty and mailed to:
    • Siebert Realty
      ATTN: our rental department
      601 Sandbridge Road
      Virginia Beach, VA 23456
    before final approval of application.
A.
B.
C.
D.
E.
F.


    


Submission of this application is authorization for item "E." referenced above in lieu of signature.