Rental Intake Questionnaire

"*" indicates required fields

Name*

First Last

Email*

Phone*

Agent that provided Initial Showing*

Desired Unit

Building address and Unit #

Number of Occupants

Desired Move-In

Month

Date

Year

Personal Information

Are you 18 Years of Age or Older*

YES

Employment History

Current or Most Recent Employer

Position

Length of Employment

Monthly Salary

Supervisor Name

First Last

Supervisor Phone #

Rental History

Present Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Move-In Date

Month

Date

Year

Move-Out Date

Month

Date

Year

Amount Paid Monthly

Landlord or Company Name

Landlord Phone Number

Landlord Email

(if available)

Reason for Leaving

If "other" please explain:

Previous Address

Previous Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Move-In Date

Month

Date

Year

Move-Out Date

Month

Date

Year

Amount Paid Monthly

Landlord or Company Name

Landlord Phone Number

Landlord Email

(if available)

Reason for Leaving

If "other" please explain:

Banking Reference

Bank Name

Bank Balance

In the account from which you pay rent

Personal References

Reference #1 Full Name

First Last

Relationship to Applicant

Phone Number

Email

Reference #2 Full Name

First Last

Relationship to Applicant

Phone Number

Email

Vehicle Information

Vehicles to be parked on premises

Not all rental units will include parking. Additional parking fees may apply. Make/Model /Year /License #

Pet Information

Pet

Not all rental units allow pets. If pets are allowed, all pets handled on a case by case basis. Reference from prior landlord and in person meeting with pet may be reuired.

Photograph of Pet

Max. file size: 256 MB.

Verification of Vaccinations

Max. file size: 256 MB.

Legal Assertations

In the past, have you been deinquent in paying rent or other financial obligations?*

Please provide yes or no in the box provided, if yes, please explain

In the past, have you ever had an eviction notice served on you?*

Please provide yes or no in the box provided, if yes, please explain

In the past, have you failed to perform any obligations of a rental agreement or have you been a defendant in an eviction lawsuit?*

Please provide yes or no in the box provided, if yes, please explain

Within the past 7 years have you filed a petition of bankruptcy?*

Please provide yes or no in the box provided, if yes, please explain

Have you ever been convicted of a felony?*

Please provide yes or no in the box provided, if yes, please explain

Has a landlord ever claimed that you have damaged their property?*

Please provide yes or no in the box provided, if yes, please explain

Rules and Regulations

Rules & Regulations for apartments vary per unit and style. Please be sure to verify these with your agent and landlord.

Broker Rental Disclosure

By completing this application it does not constitue an agency relationship, unless otherwise is agreed to in writing by the parties. All prospective tenants that have been introduced to the property by another agency, other than Parkway Real Estate LLC are responsible for any compensation to that agency. Parkway Real Estate LLC may collect an additional fee from tenant. Parkway Real Estate LLC may facilitate the delivery of funds to the owner as necesary.

Additional Terms

By signing below, I hereby state that all of the information supplied in this application is true and that all information supplied is accurate. I also authorize Parkway Real Estate LLC, their agents, landlords, and/or property management to obtain a credit report, evaluate credit, rental and employment history. The applicant authorizes the Renting Agency, Landlord, or Management Company to obtain or cause to be prepared a background report, and consumer credit report relating to the applicant if one is not self supplied. I also certify that I have reviewed the terms of the rental application and agree to all terms stated above. I understand that this is not an agreement to establish tenancy until an application is approved, a deposit is made, and a lease has been offered to me and signed by all parties.

By signing below, I am aware that certain criteria has been requested for all tenants by the landlord and that applications that do not provide all of the information required may be considered incomplete and no action taken. Prospective tenants may be required to provide verification papework. The tenant is aware that the landlord, management and/or agent may search public evictions records to verify past residency and prior landlords may be called as part of the process.

I Agree

Type your name below (digital signature):*