Application

TENANT FULL NAME *

First Name

Last Name

CURRENT ADDRESS *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

PREVIOUS ADDRESS *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

DATE OF BIRTH *

MM

DD

YYYY

PHONE # *

(###)

###

####

PREVIOUS LANDLORD (NAME) *

First Name

Last Name

PREVIOUS LANDLORD PHONE # *

(###)

###

####

WORK PHONE # *

(###)

###

####

PERSONAL REFERENCE #1 *

First Name

Last Name

PERSONAL REFERENCE #2 (NON-RELATIVE) *

First Name

Last Name

PERSONAL REFERENCE #3 (NON-RELATIVE) *

First Name

Last Name

NEAREST RELATIVE'S NAME *

First Name

Last Name

RELATIVE'S PHONE # *

(###)

###

####

I UNDERSTAND (PLEASE SELECT) *

I hereby certify that the answers I have given in this application are true and correct to the best of my knowledge, I understand that any false answers or statements made by me will be sufficient grounds for eviction and loss of any security deposit.

I hereby agree and understand that I will be charged a $50.00 USD application fee in order to complete and process this application.

In order to process this application, I hereby agree to provide Court Properties, Inc./ HL&C Companies, LLC a photocopy of my state-issued driver's license.

TODAY'S DATE *

MM

DD

YYYY