APPLICATION FOR RENTAL
EACH ADULT APPLYING FOR UNIT MUST COMPLETE A SEPARATE APPLICATION.
PLEASE PRINT – ALL information must be completed. All blanks must be filled in. The decision to rent to you will depend in great
part on your verifiable income, rental history, and background check. Only clean, honest and responsible people, who pay rent on
time, need apply.
How did you find out about us? Sign___ Internet___ Friend___ Other______________________
For Property Address:______________________________________
How long do you think you may want to live at this location? 1 year____ 1-3 years____ More than 3 years____
Are you interested in purchasing a home in the future?______________
Do you have two times the rent available today to put towards moving in? __________
Applicant Information
Name: __________________________________ Birthdate: _____________________
Soc.Sec.#: _______________________________ Driv. Lic.#: ______________________________
Home Phone: _____________________________ Cell Ph #: _________________________
Can you send and receive texts?_______
Work Phone: ________________________________E-Mail: __________________________________
What is the best way to communicate with you?_____________________________________________
Current and Previous Addresses
Present Address:_____________________________ City ___________________ST _________ZIP _____________
Owner/Manager:_____________________________ Ph #: _____________________Current rent: $ _______________
How long at this address? _____________________ When will you be ready to move?__________________________
When does the lease end? _____________________ Reason for Moving?____________________________________
Previous Address:____________________________ City ___________________ST _________ZIP _____________
Owner/Manager:_____________________________ Ph #: _____________________Rent: $ _______________
How long at this address?______________________ Reason for Moving?____________________________________
Previous Address:____________________________ City ___________________ST _________ZIP _____________
Owner/Manager:_____________________________ Ph #: _____________________Rent: $ _______________
How long at this address?______________________ Reason for Moving?____________________________________
Name and relationship of every person to live with you, even if only temporarily:
Name: ___________________________Relationship: _____________________Age:____________
Name: ___________________________Relationship: _____________________Age:____________
Name: ___________________________Relationship: _____________________Age:____________
Employment
Present Employer: ___________________________ Present Job Title: ______________________________
How long with this employer?__________________ Supervisor: ________________________Ph #: __________________
Gross Annual Income Last Year: $______________ Current Gross Monthly Income: $_________________________
Previous Employer:__________________________ Previous Job Title: ______________________________
How long with this employer? _________________ Supervisor: ________________________Ph #: ___________________
Other Sources of Verifiable Income (monthly)
Social Security: $____________________ Pension: $__________________________
Child Support:$_____________________ Other:$____________________________
Banking Information
Bank: _____________________________ Acct #:______________________ Current Balance: $__________________
Credit Card Account #:____________________________________Exp Date:____________
Balance Owed: $_______________________Monthly Payment: $________________
Vehicle(s)
1) Make:__________________Model: ___________________Year:________Lic. plate #:_______________ ST: _______
1) Make:__________________Model: ___________________Year:________Lic. plate #:_______________ ST: _______
List All Current Expenses (monthly)
Vehicle 1 Loan Balance: $___________________ Vehicle 1 Loan Payment: $__________________
Vehicle 2 Loan Balance: $___________________ Vehicle 2 Loan Payment: $__________________
Personal Loan Balance : $ ___________________ Personal Loan Payments: $__________________
Child Care: $______________________ Health Care: $ __________________
Utilities: $________________________ Telephone: $ ___________________ Other: $____________________
Additional Information
Have you ever filed for bankruptcy? ____________Ever been evicted? ___________
Ever been convicted of a felony?_______________Ever had a dispute with a previous Landlord? _________________
Have you ever been accused of being a sexual predator? ________________
Pets Name: __________________________ Pets Breed? _______________
NOTE: No pets are allowed at any time on the premises without prior
Management consent and payment of fees - NO EXCEPTIONS
Do you have a waterbed?_______________ Brand name of vacuum you own? ________________
Your attorneys name:__________________ Your doctor’s name:___________________________
Musical instruments owned:_________________________________________________________
References/Emergency Contacts:
Name:________________________________Ph #:___________________________ Email: ______________________
Relationship:_____________________________________Address: _________________________________
Name:________________________________Ph #:___________________________ Email: ______________________
Relationship:_____________________________________Address: _________________________________
I declare that the application is complete, true and correct and I herewith give my permission for anyone contacted to release the
credit or personal information of the undersigned applicant to Management or their authorized agents, at any time, for the
purposes of entering into and continuing to offer or collect on any agreement and/or credit extended. I further authorize
Management or their Authorized Agents to verify the application information including but not limited to obtaining criminal records,
contacting creditors, present or former landlords, employers and personal references, whether listed or not, at the time of the
application and at any time in the future, with regard to any agreement entered into with Management. Any false information will
constitute grounds for rejection of this application, or Management may at any time immediately terminate any agreement
entered into in reliance upon misinformation given on this application.
Applicant’s Signature: __________________________________________ Date:_______________________
In order for your application to be processed, it must be filled out thoroughly.
Each applicant needs to provide a $35 application fee, a copy of their driver’s license,
and copies of their last two paychecks OR last year’s W-2 form.
REGATTA PROPERTIES, LLP, PO Box 291, Gotha, FL 34734
Phone: 321-206-8931 Fax: 321-206-8932
www.regattaproperty.com