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PLEASE TELL US ABOUT YOURSELF
APPLICANT
MIDDLE INITIAL
FIRST NAME
LAST NAME
HOW LONG AT
THIS ADDRESS
CURRENT
ADDRESS
HOME PHONE
OTHER PHONE
BIRTH DATE
 SOCIAL SECURITY NUMBER
EMAIL
ADDRESS
DESCRIBE YOUR CREDIT HISTORY
COMMENT:
NO
YES
Have you declared bankruptcy in the past seven (7) years?
NO
YES
Have you ever been evicted from a rental residence?
NO
YES
Have you had two or more late rental payments in the past year?
NO
YES
Have you ever willfully or intentionally refused to pay rent when due?
CO-APPLICANT
MIDDLE INITIAL
FIRST NAME
LAST NAME
HOW LONG AT
THIS ADDRESS
CURRENT
ADDRESS
HOME PHONE
OTHER PHONE
BIRTH DATE
 SOCIAL SECURITY NUMBER
EMAIL
ADDRESS
COMMENT:
DESCRIBE YOUR CREDIT HISTORY
NO
YES
Have you declared bankruptcy in the past seven (7) years?
NO
YES
Have you ever been evicted from a rental residence?
NO
YES
Have you had two or more late rental payments in the past year?
NO
YES
Have you ever willfully or intentionally refused to pay rent when due?
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