Lease Application

Call About our January Leasing Specials!

Please complete and submit the online Lease Application below.

Note: There is a $20.00 application fee. Your application will not be complete until we receive this fee. Please mail or drop off your application fee at our office, located at:

5001 S. Providence Rd.
Columbia, MO 65203

If you prefer, you can download a fillable PDF using the button below and bring the completed form to our office with your $20 application fee.

Download Fillable PDF

Lease Application

General Information

How did you hear about DBC Rentals, or who referred you?

First and Last Name *

Present Street Address *

Apt

City *

State *

Zip *

Home Phone *

Cell

Date of Birth *

Email *

License #

Current Rental Information

Current Landlord

Rent Amount

Date Lease Ends

Employment Information

Employed By

For how long?

Address

Phone

Position Held

Supervisor’s Name

Monthly Income

Additional Information

Vehicle Type

Year

Lic. Plate #

State Issued

Have you ever been convicted of a felony? *

If yes, what?

Do you have a pet or pet(s)? *

Yes

Specify type(s) and size(s): *

Do you smoke? *

Have you ever been evicted? *

Have you ever been sued for rent or damages? *

Emergency Contact Information

In case of an emergency, notify: *

Relation

City

State

Phone *

In case of an emergency, notify: *

Relation

City

State

Phone *

Are you supported by your parents? *

Yes

Parent Information (If Supported by Parents)

Parent’s Name(s) *

Address (Street, City, State, Zip) *

Home Phone *

Work Phone

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation
of all statements contained in this application and credit report for tenant screening as may be necessary in
arriving at a rental decision. I understand that the landlord may terminate any rental agreement entered into for
any misrepresentation made above. I agree to pay the $20.00 non-refundable application fee.

Signature

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