Apply – River Real Estate LLC

Date Applied

Unit Requested *

Address

Date Unit Required *

Date Unit Required

Anticipated Length of Stay

Applicant *

First

Middle

Last

Name*

Phone (applicant) *

Phone*

Email (applicant) *

Email*

Marital Status (applicant)

Single
Married

S.S.N. # (applicant)

S.S.N. #

Date of Birth (applicant) *

Date of Birth

Current Address *

Address

Length of Stay (current address)

Length of Stay

Reason for Moving (current address)

Reason for Moving

Rented/Owned (current address)

Rented
Owned

if rented, Landlord's Name

First

Last

Name

Landlord's Phone (current address)

Phone

Previous Address

Address

Length of Stay (previous address)

Length of Stay

Reason for Moving (previous address)

Reason for Moving

Rented/Owned (previous address)

Rented
Owned

if rented, Landlord's Name

First

Last

Name

Landlord's Phone (previous address)

Phone

Present Employer *

Name and Address

Length of Employment (present employer) *

Length of Employment

Your Position (present employer)

Your Position

FT/PT (present employer)

Full Time
Part Time

Income (present employer) *

Income

Supervisor's Name (present employer) *

First

Last

Supervisor’s Name

Supervisor's Phone (present employer) *

Phone

Previous Employer

Name and Address

Length of Employment (previous employer)

Length of Employment

Your Position (previous employer)

Your Position

FT/PT (previous employer)

Full Time
Part Time

Income (previous employer)

Income

Supervisor's Name (previous employer)

First

Last

Supervisor’s Name

Supervisor's Phone (previous employer)

Phone

Reason for Leaving (previous employer)

Reason for Leaving

Dependent Children

Emergency Contact

First

Last

Name

Phone (emergency contact)

Phone

Address (emergency contact)

Address

Vehicle I

Year / Make / Model

License # (vehicle I)

License #

Vehicle II

Year / Make / Model

License # (vehicle II)

License #

Do you have any pets? *

Yes
No

If yes, what kind (pets)

Do you or any of the other tenants occupying the unit smoke? *

Yes
No

Have you ever been convicted of a felony? *

Yes
No

Have you ever been evicted? *

Yes
No

Have you ever filed for bankruptcy? *

Yes
No

if yes, explain (felony, evicted, bankruptcy)

(Students Only)

Will use student loans to help pay rent
Parents will help pay rent if I am unable
Will be paying rent through my present employer

*select all that apply

If applying with roommates, please list their names:

NOTES / COMMENTS:

Applicant Agreement *

*I, the undersigned, warrant the truth, completeness and accuracy of the foregoing information and hereby authorize and consent to River Real Estate, LLC obtaining further information about me and to check the information that has been given by me. River Real Estate, LLC may also disclose information about me to Credit Bureaus and other persons with whom I have, or propose to have, financial dealings, or if it believes the disclosure is required by law. I agree that this application will be retained by River Real Estate, LLC, should I enter into a rental agreement with River Real Estate, LLC, however, it will be destroyed if I do not. This information will only be used for the purpose of reviewing my rental request and follow up of the subsequent rental agreement, and no other purpose.

Signature of Applicant *