CUMBERLAND PROPERTY INVESTMENTS, LLC
LEASE TO OWN APPLICATION - Equal Housing Opportunity

The undersigned hereby makes an application to lease and purchase the following property located at: (required)

PLEASE TELL US ABOUT YOURSELF

Applicant Name (required)

Home Phone (required)

Date of Birth (required)

Social Security # (required)

Email (required)

Do you have pets? (required)
yesno

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)

Current Address City, State, Zip (required)

Month/Year Moved In (required)

Reasons for Leaving (required)

Current Rent $ (required)

Current Owner/Agent (required)

Current Owner/Agent Phone (required)

PLEASE DESCRIBE YOUR CREDIT HISTORY

Applicant

Have you declared bankruptcy in the past seven (7) years? (required)
yesno

Have you ever been evicted from a rental residence? (required)
yesno

Have you had two or more late rental payments in the past year? (required)
yesno

Have you willfully or intentionally refused to pay rent when due? (required)
yesno

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Applicant

Applicant employer (required)

Dates employed (required)

Your status:

Full time(required)
yesno

Part time(required)
yesno

Other than full or part time:

Job title

Supervisor name

Supervisor Phone (required)

Salary / Year

If employed less than six months, give name & employer of previous employer:

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. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application:

Amount $

Source/Contact Name

Source/Contact Phone

Banking Accounts:

Name

Type of Account

Current Balance $

Personal Reference or Emergency Contact:

Name

Address

ADDITIONAL INFORMATION

Please give any additional information that might help owner/management evaluate this application.

Where may we reach you to discuss this application?

Day #

I hearby submit an application to lease the above described premises for the term and upon the conditions set forth. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the hold deposit and/or applicant fee will be retained to offset the owner's cost for obtaining credit report, time, and effort in processing my application.

Applicant Name (required)

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