Credit Form Step 1 of 10 - Personal Information 0% Name of Applicant* First Last Telephone*Email* Enter Email Confirm Email Applicant's birthdateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Today's Date Are you over 18?YesNo Social Security No.Driver's License No.Present Street Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Landlord and Phone No.Current Rent AmountPrior Street Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Prior Landlord and Phone No.How long have you lived at the present address?How long have you lived at the prior address? How many adults will be living in this unit?How many children will be living in this unit?How many pets will be living in this unit?What is the weight of pets in pounds?EmployerOccupationCurrent SalaryHow long with employer (years & months)?Contact Person Telephone Is there a Co-Applicant?*YesNoName of Co-Applicant Co-Applicant Email Enter Email Confirm Email Co-Applicant's BirthdateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Co-Applicant TelephoneCo-Applicant Security No.Co-Applicant Driver's License No.Co-Applicant EmployerCo-Applicant OccupationCo-Applicant Current SalaryHow long with employer (years & months)?Contact Person Contact Person Telephone Bank NameBank TelephoneBank Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Checking Account No.Savings Account No. Number of vehicles (including company cars)Please list each vehicle below. Please include make, model, year, color, tag no. and state Have you ever filed for bankruptcy?NoYesIf yes, when?Have you ever been served an eviction notice or asked to vacate a property you were renting?NoYesIf yes, when and why?Have you ever willfully or intentionally refused to pay rent when due?NoYesIf yes, why? How were you referred to us?NewspaperRealtorFriendSignOtherPlease provide a name of the referral source you listed above Rental Unit applied forCommencement Date TermRent/Month Applicant hereby authorizes verification of any and all information set forth on this application, including release of information by any bank, savings and loan, employer (present and former), landlord, and/or other lender. All such information hereon, and released as authorized above, will be kept confidential. APPLICANT REPRESENTS THAT THE INFORMATION SET FORTH ON THIS APPLICATION IS TRUE AND COMPLETE. Material misrepresentation on this Application will constitute default under the lease or Rental Agreement between partiesApplicant must submit the sum of $25 which is processed through Paypal and is a non-refundable payment for a credit check and processing charge, receipt of which is acknowledged by Management. Such sum is not a rental payment or deposit amount. In the event this application is approved or disapproved, this sum will be retained by management to cover the cost of processing application as furnished by applicant. This Application must be signed before it can be processed by Management.Signature*Permission* I give permission to Plaza Realty to run my credit. Applicant Fee Price: $25.00 Co-Applicant Fee Price: $25.00