Name * First Name Last Name Date of Birth * MM DD YYYY Email * Phone * (###) ### #### Contact me by: * Phone Email Text If by phone, best day to call -Select- Anyday Weekdays Weekends Select Unit -Select- 3b1b- Buffalo St 2b1b -Anderson Ave 3b2.5b - Washington St 2b1b- S 4th St Number of Occupants * Do you have pets? * -Select- Yes No Desired move-in-date * MM DD YYYY Current Address * Current Landlord Name * Current Landlord Contact * (###) ### #### Length of Residence * -Select- Less than 6 Months 6 Month - 1 Year 1 Year + 2 Years + Previous Address * Previous Landlord Name * Previous Landlord Contact (###) ### #### Length of Residence * -Select- Less than 6 Months 6 Months - 1 Year 1 Year + 2 Years + Employer Name Income (Monthly) $ Other Source Income SSI Rental Assisstance Child Support Other If Other, Please Describe Total Income of Other Sources (Monthly) $ Will anyone living in the property smoke? Yes No Have you or anyone intended on living in the property been evicted? Yes No If yes, explain Have you or anyone living in the property been convicted of committing a crime? Yes No If yes, explain Additional Comments Thank you! Rental Applicationinfo@oleanpropertymanagement.com
