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APPLICANT/S INFORMATION

Applicant 1
 Applicant 2

Birthdate

 Drivers License Number

ADDRESS INFORMATION
Address
 City

 Zip

How Long At This Residence?
 Home Phone

 Mobile Phone

Present Landlord/Caretaker
 Rent Amount

Previous Address
 City

 Zip

How Long At This Residence?
 Home Phone

 Mobile Phone

Present Landlord/Caretaker
 Rent Amount

Reason For Moving



EMPLOYMENT INFORMATION
Present Employer
 Monthly Income

 Phone

Supervisor
 Address

 How Long?

Previous Employer If Applicable
 Phone

Address
 Reason For Leaving

 How Long?

Other Income (assistance, part-time job, etc.)
Monthly Income


 Phone

Other Income (assistance, part-time job, etc.)
Monthly Income


 Phone

Comments



BANK REFERENCE (indicate bank branch and services used)

Bank Name
 Account #

 Phone

Address
 City

 Zip

Account Type


Comments



EMERGENCY CONTACT
Name
 Relationship

 Phone

Address
 City

 Zip


HAVE YOU EVER BEEN CONVICTED OF A CRIME WITHIN THE PAST 10 YEARS?

Yes or No?
 Have You Been Convicted?

If Yes, Explain



MOTOR VEHICLE/S
License Plate
 Make

 Year

License Plate
 Make

 Year


LIST ALL OCCUPANTS OF UNIT

Occupant/s
 Relationship/s

 Age/s

Management will grant equal opportunity to all persons regardless of race, creed, religion, gender, sexual orientation, national origin, familial status, marital status, status with regard to public assistance and/or disability.

Is there any information that might appear on your credit, rental, or criminal history that you with to disclose and/or address up front knowing that failure to disclose such information may be considered grounds for denial of this application? 

Yes or No?

By signing below Applicant  hereby authorizes Management to verify all information listed above as well as conduct a full background/credit check.

Applicant Signature #1
 Date

Applicant Signature #2
 Date

(typed sig. holds same as live sig.)

 


our office will contact

 

Meet Our Staff

Brett Foss
Principal/Broker
Direct Dial:
651-503-1864
Boup Foss
Manager
Direct Dial:
612-232-6136
Renee Foss
Accountant
Direct Dial:
952-431-1095

 
Exclusively for Seniors
 
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   Locate Us - Contact Information

Parallel Companies Inc.
7570 W. 147th St.
Suite 308
Apple Valley, MN 55124
Phone: 952-431-1095
Fax: 952-431-1069
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