Application for Rental
Sullivan Landowners Association

Date__________________ Address applying for_____________________________________

1. Name______________________________________________ Age____________________
2. Present Address_______________________________ How Long?____________________
Name & Phone of Landlord ______________________________________________________
3. Previous Address ______________________________ How Long?____________________
Name & Phone of Landlord______________________________________________________
4. Marital Status_______________________Drivers License___________________________
5. Employer__________________________ Address__________________________________
6. Spouse’s Employer___________________ Address ________________________________
7. How Long Employed? You______________________ Spouse________________________
8. Phone Number where you can be reached________________________________________

9. List all persons to be occupying the premises:
Name________________________ Age __________ Relationship______________________

Name________________________ Age __________ Relationship______________________

Name________________________ Age __________ Relationship______________________

10. List all types of vehicles to be parked on the premises by occupant and Spouse:
Type______________________ Year________ Make ________Plate___________
Type______________________ Year________ Make ________Plate___________
Type______________________ Year________ Make ________Plate___________

11. Name of Bank___________________________ City _________________________

12. Why are you leaving your current address?_________________________________
________________________________________________________________________

13. Have you or your spouse ever been evicted?_____________ For what?__________
________________________________________________________________________

14. Have you or your spouse broken a lease or rental agreement or been sued for
non-payment of rent or damages to rental property?_____________________________

15. How were you referred to us? ____________________________________________

16. In case of emergency, notify__________________________Phone______________
Address_____________________________ Relationship_________________________

17. Do you smoke?_______________________ Do you have pets?_________________

18. Please list 2 references other than family:
Name_____________________ Address__________________ Phone___________
Name_____________________ Address__________________ Phone___________

Correct Information
Applicant represents that all of the above statements are true and hereby authorize verification of above information and references. Any incomplete or incorrect information will be cause for rejection of application.

Applicant’s Signature______________________Co-Applicant___________________