VALLEY ESTATES					● Each adult (18 or older) must fill out a separate application
					● There is a non-refundable application fee of $40.00
RENTAL APPLICATION
Equal Housing Opportunity						Address Applying For
PLEASE TELL US ABOUT YOURSELF
First		Middle		Last		Birth Date	Social Security #		Drivers License #
Any Other Names You've Used in the Past				Home Phone		Cell Phone		Work Phone		Ext.
All Other Proposed Occupants						Birth Date	Relationship to Applicant
Do you have pets?		Type		Breed
PLEASE GIVE RESIDENTIAL HISTORY
		Current Residence			Previous Residence			Prior Residence
Street Address
City
State & Zip
Last Rent Amount Paid
Owner/Manager and Phone Number
Is/Was rent paid in full?
Did you give Notice?
Were you asked to move?
Why did you move?
Have you had any reoccurring problems with your landlord?
		From/To			From/To			From/To
Dates of Residency
PLEASE GIVE EMPLOYMENT HISTORY
		Current Employment			Previous Employment			Prior Employment
Status (Full-Time, Part-Time, Student, Unemployed)
Employed By
Address
Employer's Phone
Your Job Title
Name of Supervisor
Salary
Paid per week, bi-weekly, monthly
		From/To			From/To			From/To
Dates of Employment
If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation.
Source				Amount	Per (Week/Month)		Contact Name		Contact Phone
PLEASE DESCRIBE YOUR CREDIT HISTORY
			Bank/Institution Name				Balance on Deposit or Balance Owed
Savings Account
Checking Account
Credit Card
Auto Loan
			Yes	No	If Yes, please give dates and/or explain
Have you ever been served a late rent notice?
Have you ever filed for bankruptcy? If so, when?
Have you ever been evicted from a rental residence?
Have you been a party to a lawsuit in the past? If yes, please explain why.
Have you ever willfully and intentionally refused to pay rent when due? If yes, please explain why.
Have you had two or more late rental payments in the past year?
Have you ever willfully and intentionally refused to pay rent when due? If yes, please explain why.
PLEASE DESCRIBE YOUR CRIMINAL HISTORY
			Yes	No	If Yes, please list dates and charges
Have you ever been convicted of or pleaded guilty or "no contest" to a felony and/or a misdemeanor (whether or not resulting in a conviction)?
Have you ever been convicted of or pleaded guilty or "no contest" to a misdemeanor involving sexual misconduct (whether or not resulting in a conviction)?
Are you Currently on Probation or Parole?
PLEASE LIST YOUR VEHICLES
		Year	Year		Model		Color		License Plate #
Vehicle #1
Vehicle #2
PLEASE LIST YOUR REFERENCES
		Reference #1			Reference #2			Reference #3
Name
Address
City, State and Zip
Phone Number
Relationship
PLEASE LIST YOUR EMERGENCY CONTACT (SOMEONE NOT LIVING IN YOUR HOUSEHOLD)
Name			Address			Home Phone		Work Phone		Ext.
ADDITIONAL INFORMATION
Is there anything negative that may find when researching your credit and criminal history that you want to comment on?
How did you hear about our Community?					Do you have an e-mail address we can reach you at?
AGREEMENT & AUTHORIZATION SIGNATURE (PLEASE READ CAREFULLY BEFORE SIGNING THIS APPLICATION)
In consideration of space being rented to us, we agree to hold Valley Estates operators harmless from damages caused by fire, wind storm or other acts of God and from any losses resulting from thefts or breaking in of tenant's property. We agree to leave the Park on request and with the return of any un-earned money. We understand rent is payable in advance by check or money order ONLY. NO CASH WILL BE ACCEPTED.
It is also agreed by the applicant that there will be no assignment of the use of the lost to any other person, nor occupancy of the lot by any other person without first obtaining prior written consent of Management.
I believe that the statements I have made are true and correct. I hereby authorize Valley Estates Management to obtain a credit and/or criminal check. I also give Valley Estates permission to verify all of the information that I provided and I also give Valley Estates permission to communicate with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that there is a non-refundable fee of $40.00 to cover the cost of processing my application and I am not entitled to a refund even if I don't get approved. I understand that if Valley Estates approves this application, I agree to sign the lease and pay the security deposit in full within three (3) days of acceptance.
Signed:
	Print Name				Signature				Date