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Rental Application
www.862RICE.com Rental Application
*Social Security Number
*First Name:
Middle Initial:
*Last Name:
*Address Line 1:
Address Line 2:
*Zip Code:
*Home Phone:Include area code
Business Phone:Include area code
Cell Phone:Include area code
*Date of Birth:00/00/0000
*Drivers License Number
Co-Tenant Full Name:
Car Make & Model:
Car Make & Model:
Rental History
*How long at current address?
*Landlord Name:
*Landlord Phone:
*Current Rent:Numerals only please
*Rent Paid Through:Date only
Previous Address:
How long at previous address?
Landlord Name:
Landlord Phone:
Previous Rent:Numerals only please
Rent Paid Through:Date only
*Current Occupation:
*Employer or Business Name:
*Business Address:
*Type of Business:
*Position Held:
*Supervisor Name & Title:
*Supervisor Phone:
*Start Date:Date only
*Monthly Income:Numerals only please
Savings or Checking Account
*Bank Name:
Account Number:
Bank Name:
Account Number:
Credit Reference
Other Occupants
List all other occupants, including names and relationships (include pets).
Question & Answer
*Ever Filed for Bankruptcy?
*Ever been evicted?
*Address of House/Apartment Applying For
*Requested Move In Date:Date only
I certify that the above information is true and complete. I authorize the verification of this information by contacting any or all individuals and financial institutions listed above. I understand that this is not a lease or an offer to rent. No binding obligation of any kind exists between the owner and myself unless and until a lease is signed. This Application is subject to prior Applications. This Application shall remain the property of the owner. The undersigned authorizes RICE PROPERTY MANAGEMENT & REALTY, LLC, and any consumer or credit reporting agency or bureau employed by it to investigate our (my) character, general reputation, mode of living, credit and financial responsibility and the statements made with this application and to inquire of and check with the persons and references named therein and also authorize(s) such credit or consumer reporting agency or bureau to make a consumer or credit report in connection therewith.

By submitting this form, you acknowledge that you are paying a $50.00 non-refundable application fee. Each adult (age 18 and over) to be named on the lease is required to submit a separate application.
*Application Fee
I agree that the Landlord may terminate any agreement entered into in reliance on any misstatements made above.
*Dated:Date only
By entering my first & last name below, I imply that I agree to all of the terms and conditions stipulated on this application.
*Signature: Enter first & last name