Rental Application

Full Legal Name:*
Date of Birth:*
Driver's License / State ID #:

Phone Number:*
Email Address:*

Address:
City:
State:
Zip:

Length of Stay:
Current Rent / Mortgage:
Landlord Name:
Landlord Phone:
Reason for Moving:

3. Previous Address

Address:
City:
State:
Zip:

Length of Stay:
Landlord Contact:

Company Name:
Position / Title:
Supervisor Name:
Employer Phone:
Length of Employment:
Monthly Gross Income:

Company Name:
Position / Title:
Length of Employment:

Source:
Monthly Amount:

Name / Age / Relationship:

Move-in Date:
Unit Size:

Evicted?:
Refused Rent?:
Felony?:
If yes, explain:

Name:
Relationship:
Phone:

I authorize Lake Haven Apartments to verify employment, rental history, and run background checks.

Patment Option:

Type Full Name as Signature:
Date: