VEM REALTY RESIDENTIAL RENTAL APPLICATION

For inquiries about the rental property, please contact VEMRealty at:

Email Address: vemrealty@gmail.com

Phone: (917) 477- 3737

RENTAL PROPERTY

Rental Property Address: __________, __________, NY __________

Date of Availability: Immediate

2020 Application Fee: $25.00

APPLICANT'S PERSONAL INFORMATION Name: _______________________________ Email: _____________________ Address:_______________________________________________ Home Phone: (_________) ______________ Alternative Phone: (_________) ______________ Date of Birth: _________________________

DESIRED MOVE-IN DATE: _________________

CO-APPLICANT’S PERSONAL INFORMATION (if applicable) Name:_____________________ Email: _____________________ Address:____________________________________________________

Current Address: _________________________________________________________________________ How long have you been residing at this address? _________________________________

Monthly Rent: _______________

Landlord's Name: ___________________________________________

Landlord's Contact Number: __________________________________

Reason(s) for leaving this property: ___________________________________________________________________________________ _____________________ __________________________________________________

Previous Residence (If applicable) Previous Address: _________________________________________________________________________

How long did you stay at this address? __________________________________________

Monthly Rent: _____________________

Landlord's Name: __________________________________________

Landlord's Contact Number: __________________________________

Reason(s) for leaving this property: ___________________________________________________________________________________ _____________________ __________________________________________________

Have you ever been evicted from a rental residence? Yes No

Have you missed two or more rental payments in the past 12 months? Yes No

Have you ever refused to pay rent when due? Yes No

If you have answered YES to any of the above, please state your reasons and/or circumstances: ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________

EMPLOYMENT DETAILS

I. Current Employment Employment Status: [ ] Full-Time [ ] Part-time [ ] Student [ ] Unemployed [ ] Retired

Current Employer: _________________________________________________________

Supervisor's Name: _______________________________ Phone: ________________

Job Title: _______________________________________ Date Hired: ____________________

Monthly Income:$ _________

Other Sources of Income: ___________________________________________________________________________________ ___________________________________________________________________________________ PROOF OF INCOME

The applicant is required to attach proof of their income to this rental application form. Acceptable documentation includes pay stubs, employer’s letter/certificate, bank statements or copies of the previous year’s tax return.

CREDIT HISTORY AND BACKGROUND CHECK AUTHORIZATION

Have you declared bankruptcy in the past seven (7) years? Yes No

Do you consent to a credit check? Yes No

Is there anything that we may find in our credit check that you want to comment on? ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________

ADDITIONAL INFORMATION

I. PETS

The Landlord does not allow pets in the rental property.

II. SMOKING

The Landlord does not allow smoking of cigarettes in the rental property.

III. WATERBEDS

The Landlord does not allow the use of waterbeds on the premises.

I declare that the information I have provided is true and correct, and contain no misrepresentations. If misrepresentations are found after a residential lease agreement is entered into between the Landlord and Applicant, the Landlord shall have the option to terminate the residential lease agreement and seek all available remedies. The Applicant authorizes the Landlord to verify all references and facts, including but not limited to current and previous landlords, employers and personal references. The Applicant understands that incomplete or incorrect information provided in the application may cause a delay in processing or may result in the denial of application.

Applicant's Signature ______________________ Date ___________

Co-Applicant's Signature ______________________ Date ___________