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Landlord & Property:
What Property Are You Applying For?
Property Address:
Square Feet (SF):
Property Name (if any):
Tenant/Business Owner:
Owner Name:
Ownership Percentage: %
Phone Number:
Email Address:
Title:
President
CEO
Vice President
Other
Other Title:
2nd Owner Name:
Ownership Percentage: %
Phone Number:
Email Address:
Title:
President
CEO
Vice President
Other
Other Title:
Company:
Company Name:
Company Address::
Phone Number:
E-Mail Address:
Type of Entity:
LLC
Corporation
Partnership
Other
Other Type of Entity:
State of Incorporation:
Federal TAX ID Number (FEIN):
Business Type:
(e.g. pharmacy, professional services,convenience store, etc.)
Lease Guarantee:
Name(s) of the Person(s) that will Guarantee the Lease:
Person 1:
Name:
Phone:
Email Address:
Person 2:
Name:
Phone:
Email Address:
Rental History:
Present Address:
Rent: $
/ Month
Rent
Own
Other
Other:
If Renting, Name of Landlord:
Phone:
Previous Address:
Rent: $
/ Month
Rent
Own
Other
Other:
If Rented, Name of Landlord:
Phone:
Credit Reference:
(Former Landlord, Bank, Vendor, etc.)
1st Reference:
Address:
Phone:
Email Address:
2nd Reference:
Address:
Phone:
Email Address:
Current Revenues:
Last Month(1 Month): $
Last Quarter(3 Months): $
Last Year(12 Months): $
Previous Year(12 Months): $
Banking References:
1st Account:
1st Account Bank Name:
Phone:
Bank Address:
Account Number:
Type:
Checking
Savings
2nd Account:
2nd Account Bank Name:
Phone:
Bank Address:
Account Number:
Type:
Checking
Savings
Consent:
Consent
*
I/We, the undersigned applicant(s) authorize the Landlord, or his/her/their agent to order and review my/our credit and criminal history and investigate the accuracy of the informationPage 5 of 5 contained in the application. I/We further authorize all banks, employers, creditors, credit card companies, references, and any and all other persons to provide to Landlord any and all information concerning my/our credit.
Signature:
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Name
Phone:
Email Address
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