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Valentine Sales & Management, LLC
I have two options for you to make things easier for you to get an application processes much faster.
1. You can print and completd this application and return it to my office (nite drop on the corner facing Payday Loans with a check for $40 per person. ($50 if a married couple) Make the check out to Dan Valentine.
2. You can email me that you want an on line app and I will email you an online app that will only cost $24.95 to complete and they will send me the results faster than my processing is.
Let me know your choise.... Thank you, Dan Valentine
Dan Valentine, Broker 602 866 0150 phone
12031 N. Cave Creek Rd. 602 866 151 fax
Phoenix , AZ 85020 dan@valentineteam.com
Move In Information
Property Description_______________________________________________________
Deposit _____________________________ Rent _______________________________
Contract Length _____________________ Move in date ________________________
Applicant Information
First name __________________________ Last name ___________________________
Social security number ___________________ Birth day ___________________________
Phone _______________________________ Cell phone _________________________
License _____________________________ Smoke? ____________________________
Co-Applicant Information
First name __________________________ Last name ___________________________
Social security number _________________ Birth day ___________________________
Phone _______________________________ Cell phone _________________________
License _____________________________ Smoke? ____________________________
Additional Occupants
Name ______________________________ Relationship ___________ Age __________
Name ______________________________ Relationship ___________ Age __________
Name ______________________________ Relationship ___________ Age __________
Name ______________________________ Relationship ___________ Age __________
Name ______________________________ Relationship ___________ Age __________
Current Address
Address ___________________________________________________________________
City ______________________________ State _____________ Zip _______________
Manager _____________________________ Manager Phone ______________________
Start Date __________________________ End Date ____________________________
Reason for leaving ________________________________________________________
Past Rental History
Address ___________________________________________________________________
City ______________________________ State _____________ Zip _______________
Manager _____________________________ Manager Phone ______________________
Start Date __________________________ End Date ____________________________
Reason for leaving ________________________________________________________
Employment History
Company ___________________________________________________________________
Manager _____________________________ Manager Phone ______________________
Employment Length ___________________ Monthly Pay _________________________
Co-Applicant Employment History
Company ___________________________________________________________________
Manager _____________________________ Manager Phone ______________________
Employment Length ___________________ Monthly Pay _________________________
Additional Income
Income source _______________________ Amount ______________________________
Verify with? ________________________ Phone _______________________________
Bank Information
Bank name _________________________ Account # ______________ Amount _______
Bank name _________________________ Account # ______________ Amount _______
Bank name _________________________ Account # ______________ Amount _______
Bank name _________________________ Account # ______________ Amount _______
Personal References
Name _________________________ Relationship ___________ Phone _____________
Name _________________________ Relationship ___________ Phone _____________
Name _________________________ Relationship ___________ Phone _____________
Automobile Information
Make _________________________ Model __________________ Plate $ ___________
Make _________________________ Model __________________ Plate $ ___________
Pet Information
Type _________________________ Bread __________________ Weight ____________
Type _________________________ Bread __________________ Weight ____________
Type _________________________ Bread __________________ Weight ____________
Additional Information
Have you ever been convicted of a crime? Describe and Date each one: ______
________________________________________________________________________
_________________________________________________________________________
Have you ever been evicted or declared bankruptcy? Describe and Date each one:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
________ (initials) I agree to the following statement - I represent that the information provided in this application is true, complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information is grounds for eviction.
________ (initials) I agree to the following statement - I understand that the information provided might be used by Landlord to determine whether to accept this application. I authorize Landlord to verify all the information given in this application, including past rental information, personal references and employment information provided. I authorize the Landlord to obtain a current credit and criminal background check.
________ (initials) I agree to the following statement - I understand that this application is not a rental agreement and that this application does not create any obligation on the Landlord.
The undersigned represent that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information is grounds for eviction.
Signature ________________________________________ Date ________________
Signature ________________________________________ Date ________________
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