LEASING APPLICATION FOR DICK SIMONS PROPERTIES

4172-B Summer Ave. , Memphis, TN 38122 Phone: 901-324-1136

IMPORTANT!!!

Before proceeding, THE UTILITIES ARE NOT INCLUDE WITH RENTALS. IF YOU ARE UNABLE TO HAVE THE MLGW BILL PUT IN YOUR NAME

DO NOT CONTINUE.

Ø UTILTITIES ARE NOT INCLUDED IN RENTAL.

Ø MEMPHIS, LIGHT, GAS, AND WATER BILL MUST BE PUT IN TENANTS NAME.

Ø THERE IS A $25 FEE FOR YOUR CREDIT REPORT AND EMPLOYMENT CHECK.

Ø PETS ARE ALLOWED ONLY WITH A $150 PET DEPOSIT / PER PET (INSIDE OR OUTSIDE)

Ø STOVE AND REFRIGERATOR ARE NOT INCLUDED. (EXTRA $7.50 A MO. –1 OR $12.50 A MO. – 2 )

PROPERTY LOCATION__________________________________________________ DATE_______________

RENT _____________________ DEPOSIT________________ PET DEPOSIT___________________

NAME OF APPLICANT____________________________________________________________________

SS#___________________AGE______DATE OF BIRTH____________________

MARRIED_______SINGLE_______DIVORCED_______SEPARATED___________

CELL #______________________HOME #____________________ WORK # ______________________

E MAIL ADDRESS (S)_________________________________________________________________________

NAME OF SPOUSE OR CO APPLICANT/S___________________________________

SS#____________________AGE_________DATE OF BIRTH_________________ CELL #_______________

HOME #__________________ WORK PHONE_________________EMAIL ADDRESS___________________

NAME & AGES OF CHILDREN______________________________________________________________

_______________________________________________________________________________________

WHO ELSE WILL BE LIVING IN THE PROPERTY____________________________________________

_______________________________________________________________________________________

APPLICANT EMPLOYED BY_________________________________________________________________

ADDRESS___________________________________CITY________________ST______ ZIP CODE_______

SUPERVISORS NAME____________________ SUPERVISORS PHONE #_______________________

LENGTH OF EMPLOYMENT________SALARY_________WEEKLY________MONTHLY________OTHER________

SHORT JOB DESCRIPTION____________________________________________________________________________

OTHER INCOME_________________________________________________________________________________

SPOUSE CO-APPLICANT EMPLOYED BY______________________________________________________

ADDRESS______________________________CITY_______________ST__________ ZIP CODE_________

SUPERVISORS NAME______________________________ SUPERVISORS PHONE #___________________

LENGTH OF EMPLOYMENT ________SALARY________WEEKLY_______ MONTHLY_______OTHER_________

SHORT JOB DESCRIPTION_________________________________________________________________

OTHER INCOME_____________________________________________________________________________

PRESENT ADDRESS___________________________________CITY_______________ ZIP CODE________

HOW LONG________________RENT______________ LANDLORDS NAME____________________________

PHONE #___________________ CELL PHONE #________________ REASON FOR MOVING______________

________________________________________________________________________________________

CO-APPLICANT PRESENT ADDRESS_________________________CITY___________ ZIP CODE_________

PREVIOUS ADDRESS_____________________________________LANDLORDS PHONE #_______________

NEAREST RELATIVE________________________________________PHONE__________________________

ADDRESS________________________________________________________________________________

CLOSEST FRIENDS NAME_________________________________________PHONE_____________________

ADDRESS________________________________________________________________________________

BANK_____________________ACCOUNT#________________SAVINGS#____________________

PRESENT DEBTS

1.___________________BALANCE___________MONTHLY PAYMENTS___________

2. __________________BALANCE___________MONTHLY PAYMENTS___________

3. __________________BALANCE___________MONTHLY PAYMENTS___________

VEHICLE 1 _______________________COLOR_____________TAG#______________

VEHICLE 2.________________________COLOR_____________TAG #_____________

FINANCED THRU_________________________________________________________

APPLICANTS DRIVERS LICENSE #__________________________________________

SPOUSE OR CO APPLICANTS DRIVERS LICENSE #_____________________________

DOES APPLICANT OR SPOUSE HAVE AN ARREST RECORD________ EXPLAIN________________________

_____________________________________________________________________________________________

HAVE YOU EVER GONE BANKRUPT? _____REASON______________________________________________

PET(S) _______BREED___________WEIGHT________AGE_______HOUSEBROKEN________

DATE YOU WOULD LIKE TO MOVE IN______________________________________________

DO YOU NEED APPLIANCES____________IF YES THERE IS A $7.50 FEE FOR THE FIRST APPLIANACE AND $5.00 FOR EACH ADDITIONAL ONE.

NOTICE TO APPLICANT: YOU WILL BE REQUIRED TO SIGN A LEASE, PAY A FULL SECURITY DEPOSIT, AND PAY FIRST MONTH’S RENT BEFORE OCCUPYING PREMISES. NO PETS ARE PERMITTED, NOW OR LATER, IN OR ON THE PREMISES WITHOUT AN ADDITIONAL SECURITY DEPOSIT. THIS IS AN APPLICATION ONLY AND IS SUBJECT TO APPROVAL BY OWNERS. UPON ACCEPTANCE DEPOSITS WILL NOT BE REFUNDED. I AGREE TO ALLOW DICK SIMONS PROPERTIES TO DO A CREDIT CHECK ON ME NOW AND IN THE FUTURE IF NECESSARY. I UNDERSTAND THAT I HAVE TO PAY A $25.00 CREDIT CHECK FEE, AND AN ADDITIONAL $10.00 PER APPLICATION. THE $25.00 IS NON REFUNDABLE ONCE YOU TAKE THE APPLICATION WHETHER OR NOT YOU RETURN IT OR NOT. IT IS NON REFUNDABLE UNDER ANY CONDITION. I UNDERSTAND THAT THIS APPLICATION WILL BECOME PART OF THE LEASE.

AGREED________________________________________________________ DATE__________________

AGREED________________________________________________________ DATE __________________

REG. DEPOSIT $_________________CHECK#_________________CASH_____________

PET DEPOSIT $__________________CHECK#_________________CASH_____________

CREDIT CHECK $________________CHECK#_________________CASH_____________


I, ________________________________________________ give Dick Simons Properties and my current/former landlord authorization to request/release any information concerning my residency.

RENTAL VERIFICATION

TO BE FILLED OUT BY CURRENT/FORMER LANDLORD

DICK SIMONS PROPERTIES             Date____________

________________________________________________________, who currently or presently lives at

_______________________________________ has applied for a rental house at Dick Simons Properties.

Please fill out the following information and return it to us via fax at 901-342-1136 or mailed to:

Dick Simons Properties, 4172-B Summer Ave., Memphis, TN 38122. Thanking you in advance.

Move-In date ________________ Lease expiration date____________________

Rent amount ______________ Paid as agreed Yes________ No ________

Was resident late? Yes________ No _______ if yes, how many times? ____________

Would you renew a lease with them? Yes _______ No _______

Was proper thirty (30) day notice given? Yes _______ No _______

Additional comments: ___________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Landlord/Office Manager_______________________________________________ Date_____________


Dick Simons Properties 4172 B Summer Ave Memphis, TN 38122
Phone: Cell: Fax:

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