BACKGROUND INVESTIGATION CONSENT AND APPLICATION FOR RENT FORM

White House Realtors, LLC

615-672-0302
BACKGROUND INVESTIGATION CONSENT AND APPLICATION FOR RENT FORM

An separate application must be completed for each adult over the age of 18. Cost is $50 Non-refundable per application for running credit and criminal background check. Please note that applications will not be ran until application fee is received. You may pay fee by ACH authorization given with this form or fees can also be made payable to White House Realtors, LLC. in the form of cashier's check, money order or cash. We do not accept credit card payments or personal checks. *USE AT YOUR OWN RISK. As we strive to keep all information secure, White House Realtors, LLC and Complete Screening, Inc. will not be held liable for information collected over the internet through online application or liable for any third parties helping provide this service.
Applicant Full Legal Name

First NameMiddle Initial and Last Name
Nick Names, Maiden Names, other Married Names
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SS#
Date of Birth
Drivers License No.
All States Lived In
Daytime Telephone No.

Area CodePhone Number
May we contact you at this number

YesNo
The undersigned applicant hereby gives permission to White House Realtors, LLC and Complete Screening, Inc., its employees, agents and its designated members to complete a full investigation of my application by whatever means deemed necessary. This will include, but is not limited to, education, references, MVR, Sexual Offence Registries, bankruptcy, and collection/judgement verification and verification of any other things deemed necessary. The undersigned further understands that any, and all records found will be submitted to the requester. Any misrepresentations or omissions can result in the declination of application.

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Date

MonthDayYear
Date

APPLICATION FOR RENTAL
Rental Property Applying For
Desired Move In Date
Desired Lease Term
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
your email address
example@example.com
Occupant 1 name
Relationship to Occupant 1
Occupant 2 name
Relationship to occupant 2
Occupant 3 name
Relationship to occupant 3
Occupant 4 name
Relationship to occupant 1
List Applicant/Occupant Vehicles Model/year/Tag#'s

RENTAL HISTORY
If no rental history, mark no history below

No Rental History
current or most recent rental Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rent Amount
Landlord Name
Landlord Phone

Area CodePhone Number
Rented from date to date
Reason for leaving
other previous rental Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rent Amount

Landlord Name
Landlord Phone

Area CodePhone Number
Rented from date to date
Reason for leaving
EMPLOYEMENT
Current Employer
Employment Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Monthly Income Amt $
Hire Date

MonthDayYear
Date
Supervisor
Phone Number

Area CodePhone Number
OTHER SOURCE OF INCOME
Other Source of income
Other Income Amount $
Paid Per
Additional Comments
MISCELLANEOUS
Do you have pets?
If so, how many pets?
Please describe
Note: There may be additional fees and/or deposits required for pets on premises. In addition, specific rules and regulations regarding pets may apply.
Do you or any of the occupants smoke or vape?
Explain:
Have You Ever Been Evicted?
If you were ever evicted, tell us when? Explain below
Have you ever been convicted of a felony? Choose Yes or no
If you have said yes to felony, explain below
Have you ever filed bankruptcy? Choose Yes or NO
If yes, when?
Are you a US citizen?
EMERGENCY CONTACT
Emergency Contact Name

First NameLast Name
Relationship to you
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
(Emergency contact) Known for how long?
PERSONAL REFERENCES
Personal reference Name #1

First NameLast Name
Relationship to you
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
(personal reference #1) Known for how long?
Personal reference name #2

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
(personal reference name #2) Known for how long?
Personal reference name #3

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
(Personal reference name #4) Known for how long?
I hereby certify and affirm that all information provided is true and correct. Any false information may result in denial of this application, forfeiture of deposit or cancellation of lease/rental agreement. I hereby authorize verification of all information, including financial, credit and criminal information, via credit bureaus and/or contact with current and previous employers, current and previous landlords and personal references. The undersigned applicant hereby gives permission to White House Realtors, LLC and Complete Screening, Inc., its employees, agents and its designated members to complete a full investigation of may application by whatever means deemed necessary. This will include, but is not limited to, education, references, MVR, Sexual Offence Registries, bankruptcy, and collection/judgement verification and verification of any other things deemed necessary. The undersigned further understands that any, and all records found will be submitted to the requester. Any misrepresentations or omissions can result in the declination of application.

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Date Signed

MonthDayYear
Date
PLEASE PROVIDE COPY OF DRIVER'S LICENSE

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We will need a copy of driver's license for each applicant. You may choose to upload them here, fax them to 615-672-8344 or by email to whitehouserealtors@yahoo.com Cancelof
Please provide a copy of latest check stub from employer

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Signature

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Should be Empty:

White House Realtors, LLC

BACKGROUND INVESTIGATION CONSENT AND APPLICATION FOR RENT FORM

APPLICATION FOR RENTAL