Asset Assistance Co., LLC Rental Application
ASSET ASSISTANCE CO LLC
430 E LEE STREET
TUCSON, ARIZONA 85705
(520)884-3410 - FAX 622-2223
RESIDENTIAL RENTAL APPLICATION
(each co-resident must submit a separate application)
Date:________________________________________________________
Applicant's Full Name:_________________________________________________
Phone:________________________________________________________
Present address:_______________________________________________________________________
Permanent address:_____________________________________________________________________
Social Security:____________________________ Date of Birth:______________________________
How many persons will occupy this premises:_________________
Employment History
Current Employer:______________________ Company Phone:__________________________________
Address:____________________________________________________________________________________________
Gross Weekly earnings:________________________________
Employed From:________________________ To: _______________________
Position:______________________________________________________
Residential History
Current Landlord:_________________________________________
Address:__________________________________________________________________________________
Landlord's Phone:(_____)_____________________________ From:________________To:________________
Monthly Payments:___________________________________________
Reason for Moving:______________________________________________________________________
Late rental payments (ever - circle one): Yes No Eviction (circle one): Yes No
Explain if you answered yes to either question: ____________________________________________________
Bank References
Name of Bank:___________________________________Branch:________________________________
Contact:____________________________________________________________________
Checking account number:_________________________________________
Savings account number:_________________________________________
Vehicles
Year:___________ Make:________________ Model:_______________ License number:_______________
State:________________
Year:___________ Make:________________ Model:_______________ License number:_______________
State:________________
Emergency Information
Name:________________________________ Relationship:___________________________________
Phone: (____)_________________________
I/We do hereby consent to and authorize the landlord and /or his agents to obtain, verify and exchange information on any reports concerning me as are maintained by, but not limited to: City, County, State, Federal Law Enforcement Agencies, Credit Reporting Agencies, present and/or past employers including but not limited to present and/or past salary verification, present and/or past residences. I understand that any information obtained may be considered by the landlord and/or his agents in their sole discretion, as a factor in decisions they make with respect to the property for which I am applying.
Furthermore, I hereby release and hold harmless any Credit Reporting Agencies, present and past employers, present and past landlords, and their agents, owners, and affiliates(including but not limited to officers, directors and employees) who provide information to landlord and/or his agents, upon request, from any and all claims, demands, suits, or expenses arising from or related to the content, validity or handling of said information.
I hereby certify that I have read and reviewed the information contained in this application. I am in agreement that this information is accurate, full and complete. Any discrepancy or lack of information will result in immediate rejection of this application. I understand that this is an application and does not constitute a lease agreement in whole or part.
Initial
I understand that my deposit may be applied toward any rent loss, advertising costs, re-rental fees, etc., if this application is approved and I am unable to fulfill the conditions of occupancy. I hereby acknowledge a Non-refundable fee in the form of cashier check, money order, personal check or cash in the amount of $15.00 made payable to Asset Assistance to be used in the processing of this application.
Signature:___________________________________ Date:___________________________________
Official Use Only
Verification Completed by:___________________________________________________
Approved:_________________ Denied:_________________
Reason:________________________________________________________________________________________