Lease Application

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Lease Application

If you are human, leave this field blank.

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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