Application for Tenancy

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This form must be filled out completely and submitted to be considered for a rental by Kophamer & Blean Realty Property Management Division. Upon reviewing your application, we will contact you with any questions or concerns. Landlord has right to do background check on all applicants.

Email *

Name *

Date of birth: *

YYYY

Current Address *

Phone Number *

Currently Employed? *

Yes

Length of Employment: *

Monthly Take-Home Pay (for all renters) *

Are you able to show proof of income? *

Yes

How many people will be living in the rental? *

If more than one person is going to be living in this rental, please name them below: *

Pets: *

Yes

Type of Pets (type N/A if not applicable) *

Any special needs? (ex: handicap accessible) *

Please specify type of rental you are looking for including town and number of bedrooms (property address if applicable) *

Have you ever been convicted of a felony? *

Yes

If you answered yes, please explain the circumstances below:

Reference #1: Please include name and phone number: *

Reference #2: Please include name and phone number: *

Reference #3: Please include name and phone number: *

By submitting this application, you affirm that all information provided is accurate. *

Yes

Required

A copy of your responses will be emailed to the address you provided.

Submit

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