If more than 1 person applying, please fill out both A & B.

A. NAME __________________________________ DOB _______ SOC. SEC. # ___________ DRIVER'S LICENSE # _____________

B. NAME __________________________________ DOB _______ SOC. SEC. # ___________ DRIVER'S LICENSE # _____________

A. PRESENT ADDRESS ______________________________________________________________

PHONE # __________________ EMAIL _______________________ LENGTH OF RESIDENCE _______

PRESENT LANDLORD __________________________ PHONE # _____________________

PLACE OF EMPLOYMENT _______________________ LENGTH OF EMPLOYMENT _______

SUPERVISOR NAME ___________________________

EMPLOYER ADDRESS & PHONE # __________________________________________________

YEARLY GROSS INCOME [ ] $10,000 - $15,000 [ ] $15,001 - $20,000 [ ] Over $20,000

B. PRESENT ADDRESS ______________________________________________________________

PHONE # __________________ EMAIL _____________________ LENGTH OF RESIDENCE _______

PRESENT LANDLORD __________________________ PHONE # _____________________

PLACE OF EMPLOYMENT _______________________ LENGTH OF EMPLOYMENT _______

EMPLOYER ADDRESS & PHONE # __________________________________________________

SUPERVISOR NAME ___________________________

YEARLY GROSS INCOME [ ] $10,000 - $15,000 [ ] $15,001 - $20,000 [ ] Over $20,000

NUMBER OF PERSONS TO OCCUPY APT. ________________________

A. AUTOMOBILES MAKE _______________________ MODEL _____________________

COLOR ______________________ LICENSE PLATE # _______________

B. AUTOMOBILES MAKE _______________________ MODEL _____________________

COLOR ______________________ LICENSE PLATE # _______________

REFERENCES: Please list landlord, employer or someone other than a family member.

A. NAME ___________________________________ PHONE # ____________________

A. NAME ___________________________________ PHONE # ____________________

B. NAME ___________________________________ PHONE # ____________________

B. NAME ___________________________________ PHONE # ____________________

A. NAME OF FINANCIAL INSTITUTION ____________________ PHONE # ______________

Please include the account numbers where appropriate.

CHECKING ________________ SAVINGS ______________ OTHER ___________

B. NAME OF FINANCIAL INSTITUTION ____________________ PHONE # ______________

Please include the account numbers where appropriate.

CHECKING ________________ SAVINGS ______________ OTHER ___________

A. IN CASE OF EMERGENCY NOTIFY _____________________________________________

ADDRESS & PHONE # ________________________________________________________

NEAREST RELATIVE ____________________________________________________

ADDRESS & PHONE # ________________________________________________________

Why are you leaving your current residence? _______________________________________

Have you ever filed a petition for bankruptcy? _________ Have you ever been evicted from any

tenancy? ____ Have you ever willfully and intentionally refused to pay any rent when due? ______

Will you allow a credit check? ______ Will you allow a police records check? _______ How will your

rent be paid? Personal check _______ Money Order ___________

B. IN CASE OF EMERGENCY NOTIFY _____________________________________________

ADDRESS & PHONE # ________________________________________________________

NEAREST RELATIVE ____________________________________________________

ADDRESS & PHONE # ________________________________________________________

Why are you leaving your current residence? _______________________________________

Have you ever filed a petition for bankruptcy? _________ Have you ever been evicted from any

tenancy? ____ Have you ever willfully and intentionally refused to pay any rent when due? _____

Will you allow a credit check? ______ Will you allow a police records check? _______ How will your

rent be paid? Personal check _______ Money Order ___________

DATE OF OCCUPANCY DESIRED: __________________

I DECLARE THE FOLLOWING TO BE TRUE UNDER PENALTY OF PERJURY, I agree that landlord may terminate any agreement entered into in reliance on any misstatement made above.

A. APPLICANT ______________________ DATE ____________________________

B. APPLICANT ______________________ DATE ____________________________

There is a $25 application fee. Thorstenson Management will not process the application without receiving the fee.