To Log in or Sign Up for My Property FinderClick Here

Angie Wilson-Klimas

Direct: (256) 683-9721
Send me an Email

                                           
Please right click and print and e-mail or fax to me.  I will get it processed as quickly as possible.   Thank you.                
                                                                                                                                                                           

RE/MAX DISTINCTIVE                                                                                                                             PROPERTY MANAGER: Angie Wilson
7618 MEMORIAL PKWY. S.                                                                                                                                                          (256) 683-9721
HUNTSVILLE, AL 35802                                                   
(PLEASE PRINT)                                                                           FAX:(256) 425-0309

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

___________________________________________________________             ______________________                   ________________

                ADDRESS OF PROPERTY APPLIED FOR                                         OCCUPANCY DATE                           DATE APPLIED

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

NAME OF APPLICANT: __________________________________________________________________

CURRENT ADDRESS: __________________________________________________________________________________________

                                    STREET                                                           CITY                              STATE                    ZIP

PHONE#:(HM)____________________(WK)_____________________(CELL)______________________

EMAIL ADDRESS: ______________________________________________________________________

SOC.SEC. #: ___________________________      DR.LIC. #: __________________      DATE OF BIRTH_____________

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

NAME OF CO-APPLICANT: _______________________________________________________________

CURRENT ADDRESS: __________________________________________________________________________________________

                                    STREET                                                            CITY                              STATE                   ZIP

PHONE#:(HM)____________________(WK)_____________________(CELL)______________________

EMAIL ADDRESS: ______________________________________________________________________

SOC.SEC. #: ___________________________      DR.LIC. #: __________________      DATE OFBIRTH______________

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

ADDITIONAL OCCUPANTS:

NAME _________________________ AGE ______ RELATIONSHIP _____________________________ 

NAME _________________________ AGE ______ RELATIONSHIP _____________________________ 

NAME _________________________ AGE ______ RELATIONSHIP _____________________________ 

NAME _________________________ AGE ______ RELATIONSHIP _____________________________ 

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

PETS: HOW MANY & TYPE OF PET (S): ___________________________________________________

(INFO. MUST BE DISCLOSED PRIOR TO LEASING PROPERTY & IS SUBJECT TO APPROVAL BY AGENT. PET FEE WILL BE REQUIRED
UPON APPROVAL.)

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

                 PREVIOUS RENTAL HISTORY


CURRENT
ADDRESS: ___________________________________________FROM: ________ TO: ________

REASON FOR LEAVING: ______________________________________________ RENT AMT: _________

LANDLORD'S NAME: ___________________________________________ PHONE #: ______________

 

ADDRESS: ___________________________________________________FROM: ________ TO: ________

REASON FOR LEAVING: ______________________________________________ RENT AMT: _________

LANDLORD'S NAME: ___________________________________________ PHONE #: ______________

 

ADDRESS: ___________________________________________________FROM: ________ TO: ________

REASON FOR LEAVING: ______________________________________________ RENT AMT: _________

LANDLORD'S NAME: ___________________________________________ PHONE #: ______________

 

ADDRESS: ___________________________________________________FROM: ________ TO: ________

REASON FOR LEAVING: ______________________________________________ RENT AMT: _________

LANDLORD'S NAME: ___________________________________________ PHONE #: ________________

 

 

        CRIMINAL HISTORY

You must answer the following questions completely and truthfully. If any of the answers are false, misleading or
incomplete, your
application may be rejected, OR, if move-in has occurred, you may be evicted.

 

                                                                                                                    No    Yes       If yes, you MUST answer the following:

*Have you or any member of your household ever been convicted     __     __     Who?___________________ When?_________
of drug-related activity?                                                                                                
Details:_________________________________

*Have you or any member of your household ever been convicted     __     __     Who?___________________ When?_________
of violent criminal activity?                                                                                           
Details:_________________________________

*Are you or any member of your household a current illegal user of    __     __      Who?__________________________________
or addicted to a controlled substance?                                                                      
Details:_________________________________

*Have you or any member of your household ever been convicted     __     __    Who?___________________ When?_________
of the illegal manufacture or distribution of a controlled substance?                      
Details:_________________________________

*Have you or any member of your household ever been on parole     __     __     Who?___________________ When?_________
or are now on parole?                                                                                                 
Details:_________________________________

*Have you or any member of your household currently or in the         __     __     Who?___________________ When?_________
past used illegal drugs?                                                                                              
Details:_________________________________

*Have you or any member of your household subject to registration __     __     Who?___________________ When?_________
under a state sex offender registration program?                                   
Details:_________________________________

 

          SOURCES OF INCOME FOR APPLICANT (FROM EMPLOYER, AGENCY OR PERSON)


NAME & ADDRESS OF SOURCE:___________________________________________________________

NAME OF CONTACT TO VERIFY INCOME:__________________________ PHONE #:________________

INCOME:____________PER______(HR,WEEK,MONTH,YEAR)         AVERAGE ANNUAL INCOME:___________

HOW LONG EMPLOYED AT THIS COMPANY:______________

 

NAME & ADDRESS OF SOURCE:___________________________________________________________

NAME OF CONTACT TO VERIFY INCOME:__________________________ PHONE #:________________

INCOME:____________PER______(HR,WEEK,MONTH,YEAR)         AVERAGE ANNUAL INCOME:___________

HOW LONG EMPLOYED AT THIS COMPANY:______________

      

     SOURCES OF INCOME FOR CO-APPLICANT (FROM EMPLOYER, AGENCY OR PERSON)


NAME & ADDRESS OF SOURCE:___________________________________________________________

NAME OF CONTACT TO VERIFY INCOME:__________________________ PHONE #:________________

INCOME:____________PER______(HR,WEEK,MONTH,YEAR)         AVERAGE ANNUAL INCOME:____________

 

NAME & ADDRESS OF SOURCE:___________________________________________________________

NAME OF CONTACT TO VERIFY INCOME:__________________________ PHONE #:________________

INCOME:____________PER______(HR,WEEK,MONTH,YEAR)         AVERAGE ANNUAL INCOME:____________

     
     AUTOMOBILES & OTHER VEHICLES

OWNER NAME:______________MAKE/MODEL:________________YEAR:_____COLOR:_________TAG#:__________

OWNER NAME:______________MAKE/MODEL:________________YEAR:_____COLOR:_________TAG#:__________

OWNER NAME:______________MAKE/MODEL:________________YEAR:_____COLOR:_________TAG#:__________

 

     BANKING & CREDIT REFERENCES

NAME OF APPLICANT’S BANK:_____________________ BRANCH:___________ ACCT.#:___________

NAME OF CO-APPLICANT’S BANK:__________________ BRANCH:___________ ACCT.#:___________

CREDIT REFERENCE:_____________________ ACCT.#:___________________ MO.PMT:___________

CREDIT REFERENCE:_____________________ ACCT.#:___________________ MO.PMT:___________

 

      PERSONAL REFERENCES-NOT RELATED TO YOU

NAME:___________________________________ ADDRESS:____________________________________________PHONE:____________________

NAME:___________________________________ ADDRESS:____________________________________________PHONE:____________________

NAME:___________________________________ ADDRESS:____________________________________________PHONE:____________________

 

    EMERGENCY CONTACT

NAME:__________________________________ ADDRESS:_____________________________________________PHONE:____________________

NAME:__________________________________ ADDRESS:_____________________________________________PHONE:____________________

 

 APPLICANT/CO-APPLICANT CERTIFICATION

I certify that all information given in this application is true, complete and accurate.

I authorize Management to make any and all inquiries to verify this information either directly or through information exchanged now or later with rental
and credit screening services, previous and current landlords, law enforcement agencies, including the Sexual Offender Registries or other sources for verification confirmation which may be released to appropriate Federal, State or local agencies. 

Please read carefully before you sign and make sure all questions have been answered. By signing this application, you acknowledge that 
you have read & agree with the four certification statements listed above. You also acknowledge and agree that the application fee is non-refundable even if you are not approved. You also acknowledge and agree that any deposit paid to hold a unit for you will be refunded to you if you are not approved; however, if you are approved, but decide not to lease a unit, your deposit will not be refunded.

 

Signature: __________________________________________________ Date: _________________

 

Signature: __________________________________________________ Date: _________________

 

    
                                                   
NON-REFUNDABLE APPLICATION FEE OF $60.00 (CASH ONLY)
                                                     REQUIRED PRIOR TO PROCESSING OF THIS APPLICATION.

 

                                                          PLEASE INCLUDE A COPY OF YOUR DRIVER’S LICENSE

 

                                                                             (Do not write below this line)

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

APPLICATION APPROVED_____ or DENIED______   ____________ / ________________________

DATE: __________________________   AGENT SIGNATURE: _____________________________________

 TERMS: ___yr/mo.lease/$______mo.rent/$______deposit/$_____pet fee &/or $_____pet dep.

 Move-in date: ___________ Misc.terms: _______________________________________________

 

 

 

 

© 2001-2017 Reliance Network and RE/MAX Alabama. All rights reserved. US Reg. Copyright TX-5-910-991, TX-5-910-992, TX-5-910-993, and TX-5-910-994.
Each RE/MAX® Office is Independently Owned and Operated. Equal Housing Opportunity.


The Miracle Home® Program, exclusive to RE/MAX LLC., allows a RE/MAX Associate to make a donation on behalf of each transaction to Children's Miracle Network. The partnership underscores Sales Associate involvement in the communities in which they live and serve. RE/MAX Sales Associates are unique in that a majority of the donations received by Children's Miracle Network from RE/MAX are the result of Associates' hard work rather than solicited from customers.

 Site Map