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LEASING APPLICATION FOR THE HOUSE RENTER
(DICK SIMONS PROPERTIES)
3858 Summer Ave. , Memphis, TN 38122 Phone: 901-324-1136
IMPORTANT!!!
Before proceeding, THE UTILITIES ARE NOT INCLUDE WITH RENTALS. IF YOU ARE UNABLE TO HAVE THE MLGW BILL PUT IN YOUR NAME
DO NOT CONTINUE.
Ø UTILTITIES ARE NOT INCLUDED IN RENTAL.
Ø MEMPHIS, LIGHT, GAS, AND WATER BILL MUST BE PUT IN TENANTS NAME.
Ø THERE IS A $25 FEE FOR YOUR CREDIT REPORT AND EMPLOYMENT CHECK.
Ø PETS ARE ALLOWED ONLY WITH A $150 PET DEPOSIT / PER PET (INSIDE OR OUTSIDE)
Ø STOVE AND REFRIGERATOR ARE NOT INCLUDED. (EXTRA $25.00 A MO. EACH)
PROPERTY LOCATION________________________________________________ DATE_______________
RENT _____________________ DEPOSIT_______________________ PET DEPOSIT_________________
NAME OF APPLICANT____________________________________________________________________
SS#___________________AGE__________DATE OF BIRTH____________________
MARRIED_______SINGLE_______DIVORCED_______SEPARATED___________
CELL #______________________HOME #_____________________ WORK # ______________________
E MAIL ADDRESS (S)
______________________________________________________________________________________
NAME OF SPOUSE OR CO APPLICANT/S____________________________________________________
SS#____________________AGE_________DATE OF BIRTH_________________ CELL #______________
HOME #__________________ WORK PHONE_________________EMAIL ADDRESS___________________
NAME & AGES OF CHILDREN______________________________________________________________
______________________________________________________________________________________
WHO ELSE WILL BE LIVING IN THE PROPERTY______________________________________________
______________________________________________________________________________________
APPLICANT EMPLOYED BY________________________________________________________________
ADDRESS__________________________________CITY________________ST______ ZIP CODE_______
SUPERVISORS NAME____________________ SUPERVISORS PHONE #_______________________
LENGTH OF EMPLOYMENT________SALARY_________WEEKLY________MONTHLY________OTHER______
SHORT JOB DESCRIPTION__________________________________________________________________________
OTHER INCOME_______________________________________________________________________________
SPOUSE CO-APPLICANT EMPLOYED BY_____________________________________________________
ADDRESS______________________________CITY_______________ST__________ ZIP CODE________
SUPERVISORS NAME______________________________ SUPERVISORS PHONE #__________________
LENGTH OF EMPLOYMENT ________SALARY________WEEKLY_______ MONTHLY_______OTHER________
SHORT JOB DESCRIPTION________________________________________________________________
OTHER INCOME_______________________________________________________________________________
PRESENT ADDRESS___________________________________CITY_____________ ZIP CODE________
HOW LONG________________RENT______________ LANDLORDS NAME__________________________
PHONE #___________________ CELL PHONE #________________ REASON FOR MOVING____________
______________________________________________________________________________________
CO-APPLICANT PRESENT ADDRESS_________________________CITY___________ ZIP CODE_______
PREVIOUS ADDRESS_____________________________________LANDLORDS PHONE #_____________
NEAREST RELATIVE________________________________________PHONE________________________
ADDRESS______________________________________________________________________________
CLOSEST FRIENDS NAME_________________________________________PHONE___________________
ADDRESS______________________________________________________________________________
BANK_____________________ACCOUNT#________________SAVINGS#__________________
PRESENT DEBTS
1.___________________BALANCE___________MONTHLY PAYMENTS___________
2. __________________BALANCE___________MONTHLY PAYMENTS___________
3. __________________BALANCE___________MONTHLY PAYMENTS___________
VEHICLE 1 _______________________COLOR_____________TAG#______________
VEHICLE 2.________________________COLOR_____________TAG #_____________
FINANCED THRU_________________________________________________________
APPLICANTS DRIVERS LICENSE #__________________________________________
SPOUSE OR CO APPLICANTS DRIVERS LICENSE #_____________________________
DOES APPLICANT OR SPOUSE HAVE AN ARREST RECORD________ EXPLAIN________________________
_______________________________________________________________________________________
HAVE YOU EVER GONE BANKRUPT? _____REASON______________________________________________
PET(S) _______BREED___________WEIGHT________AGE_______HOUSEBROKEN________
DATE YOU WOULD LIKE TO MOVE IN______________________________________________
DO YOU NEED APPLIANCES____________IF YES THERE IS A $25.00 FEE FOR THE FIRST APPLIANACE AND $25.00 FOR EACH ADDITIONAL ONE.
NOTICE TO APPLICANT: YOU WILL BE REQUIRED TO SIGN A LEASE, PAY A FULL SECURITY DEPOSIT, AND PAY FIRST MONTH’S RENT BEFORE OCCUPYING PREMISES. NO PETS ARE PERMITTED, NOW OR LATER, IN OR ON THE PREMISES WITHOUT AN ADDITIONAL SECURITY DEPOSIT. THIS IS AN APPLICATION ONLY AND IS SUBJECT TO APPROVAL BY OWNERS. UPON ACCEPTANCE DEPOSITS WILL NOT BE REFUNDED. I AGREE TO ALLOW DICK SIMONS PROPERTIES TO DO A CREDIT CHECK ON ME NOW AND IN THE FUTURE IF NECESSARY. I UNDERSTAND THAT I HAVE TO PAY A $25.00 CREDIT CHECK FEE, AND AN ADDITIONAL $10.00 PER APPLICATION. THE $25.00 IS NON REFUNDABLE ONCE YOU TAKE THE APPLICATION WHETHER OR NOT YOU RETURN IT OR NOT. IT IS NON REFUNDABLE UNDER ANY CONDITION. I UNDERSTAND THAT THIS APPLICATION WILL BECOME PART OF THE LEASE.
AGREED________________________________________________________ DATE__________________
AGREED________________________________________________________ DATE __________________
REG. DEPOSIT $_________________CHECK#_________________CASH_____________
PET DEPOSIT $__________________CHECK#_________________CASH_____________
CREDIT CHECK $________________CHECK#_________________CASH_____________
I, ________________________________________________ give The House Renter (Dick Simons Properties) and my current/former landlord authorization to request/release any information concerning my residency.
RENTAL VERIFICATION
TO BE FILLED OUT BY CURRENT/FORMER LANDLORD
DICK SIMONS PROPERTIES Date____________
________________________________________________________, who currently or presently lives at
_______________________________________ has applied for a rental house at Dick Simons Properties.
Please fill out the following information and return it to us via fax at 901-342-1136 or mailed to:
Dick Simons Properties, 3858 Summer Ave., Memphis, TN 38122. Thanking you in advance.
Move-In date ________________ Lease expiration date____________________
Rent amount ______________ Paid as agreed Yes________ No ________
Was resident late? Yes________ No _______ if yes, how many times? ____________
Would you renew a lease with them? Yes _______ No _______
Was proper thirty (30) day notice given? Yes _______ No _______
Additional comments: ___________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Landlord/Office Manager_______________________________________________ Date______________
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