CUMBERLAND PROPERTY INVESTMENTS, LLC
APPLICATION TO RENT - Tenant's Personal & Credit Information

PERSONAL DATA

Applicant Name (required)

Maiden Name or Alias/If Divorced, Previous Name

Date of Birth (required)

Social Security # (required)

Present Address City, State, Zip (required)

How long at present address? (required)

Reason for Moving (required)

Current rent $(required)

Current Landlord Name (required)

Current Landlord Phone (required)

OCCUPATION

EMPLOYER

Present Occupation

SELF-EMPLOYED, D.B.A.

Present Occupation

BUSINESS ADDRESS CITY, STATE, ZIP

Present Occupation

BUSINESS PHONE

Present Occupation

POSITION HELD

Present Occupation

HOW LONG, POSITION HELD

Present Occupation

NAME AND TITLE OF SUPERVISOR

Present Occupation

MONTHLY GROSS INCOME

Present Occupation

MONTHLY LIVING EXPENSES

Present Occupation

REFERENCES

Please list and indicate all saving(s) and checking (ck) accounts

Bank Name

Balance

Year Opened

PERSONAL REFERENCES

Name

Address

Phone

Relationship

Additional Information

CREDIT BALANCES & OUTSTANDING LOANS

Creditor

Balance Owed

Date Opened

Additional Information



Address of premises offered for rent:

Rental price/month

Landlord/agent agrees that the deposit is refundable if the above applicant is not approved, providing that this application has been filled out completely and truthfully.

Have you owned a home in the past

If yes, how long?

Have you ever filed a petition for bankruptcy?

If yes, when?

Have you ever been evicted from any tenancy?

Have you ever willfully and intentionally refused to pay rent when due?

I hereby authorize landlord/agent to verify the validity of all the above information, and to inquire now or periodically with my employers, financial institutions, and any of the credit reporting bureaus available to him. I agree to supply any additional information needed by owner/agent to process this application and I acknowledge my deposit will be forfeited if I do not comply with any such request. I hereby acknowledge receipt of a copy of this application agreement. I agree that landlord may terminate any agreement entered into in reliance on any misstatement made above. I declare, under penalty of perjury, all of the above information to be true and correct, to the best of my knowledge.

Applicant

By checking the box, you are agreeing that the above information, to the best of your knowledge, is true and correct.

Today's Date