CHUCKANUT PROPERTY MANAGEMENT

Non-Refundable 1012 DUPONT STREET

Application Fee BELLINGHAM, WA. 98225

Required to Process (360) 733-3640

all applications (360) 647-0526

RENTAL APPLICATION

DATE:

NOTICE: Co-applicant must complete a separate rental application form.

The undersigned hereby makes application to rent the unit located at:

beginning on 20 , at a monthly rental amount of

PLEASE TELL US ABOUT YOURSELF

FULL NAME Phone ( )

Date of birth Social Security No.

Name of Co-Applicant

Spouse’s date of birth Spouse’s Social Security No.

Number of Dependents (excluding Co-Applicant)

Name and Age of Dependents

Other Occupants

Pets (Number and Kind)

PLEASE GIVE YOUR RESIDENCE HISTORY FOR THE PAST 3 YEARS (beginning with most current)

CURRENT ADDRESS City State Zip

Month and Year Moved in Rent $ Reason for leaving

Owner or Agent Phone #

PREVIOUS ADDRESS (If within 3 years) City State Zip

Month and Year Moved In Moved Out Rent $

Reason for leaving

Owner or Agent Phone #

PLEASE GIVE YOUR EMPLOYMENT INFORMATION

Employed Full-Time Employed Part-Time Student Retired Unemployed

CURRENT EMPLOYER

Company Name Business Phone

Position How long employed

Supervisor Salary $ per

SPOUSE EMPLOYER

Company Name Business Phone

Position How long employed

Supervisor Salary $ per

OTHER INCOME NOT RELATED TO EMPLOYMENT (ie: SSI, Child Support)

Source Amount per

PREVIOUS EMPLOYER (if less than 1 year)

Company Name Business Phone

Position How long employed

Supervisor Salary $ per

OTHER INFORMATION

Please give us your vehicle(s) make/model/color

Please give us your driver’s license number

Please give us spouses driver’s license number

Are you or your spouse a smoker?

Credit Cards (name only) Average Monthly Payment

Car Payment

Other

HAVE YOU EVER:

Filed for bankruptcy? € No € Yes

Been evicted from tenancy? € No € Yes

Been convicted of a misdemeanor or felony? € No € Yes

Parents or Closest Relative (For Emergency Purposes)

Name Phone Number

Spouse’s Parent or Closest Relative

Name Phone Number

Please give any additional information which might help management evaluate this application:

I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews neighbors, friends, and others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, and mode of living. My employer(s) will also be contacted regarding my employement history as well as my current salary verification. I understand that I may have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

The above information, to the best of my knowledge, is true and correct.

Signature of Applicant Date Signed

APPLICANT: PLEASE DO NOT WRITE BELOW

Reference Verification Name Reference Comments