Online Application

Park Place Property Management Online Application

There is a $35.00 charge for any applicant over the age of 18.
This can be paid using our online payment screen.

General Information

* Required Fields

Today's Date:		*
The undersigned hereby makes application to rent the property located at *
beginnning (mm/dd/yyyy) , for a term of
for $ * per month, and submits the following information: *

First Name:		*
Middle Name:		*
Last Name:		*
Street Address:		*
City:		, Zip: *
Phone - Home:
Phone - Work :
Phone - Mobile:		*
Date of Birth:		* (mm/dd/yyyy)
Social Security Number:		* (000-00-0000)
Monthly Income $		*
Additional Sources of Funds:
Country of Citizenship:		* If not the United States, submit immigration status papers
Email:		*
Referred by:

Dependents

	Name	DOB	Relation
Dependent 1
Dependent 2
Dependent 3

Other Occupants

	First Name	Last Name	DOB	Relation	SSN #
Occupant 1
Occupant 2
Occupant 3

Pets (If applicable)

Type (ex. dog, cat, etc.)	Breed	Size (lbs.)	Color

Rental History Information

Rental 1: (If none state so)
Date Start:		*
Date End:		*
Owner:		*
Owner Phone:		*
Street Address:
City:
State:
Zip:
Reason/leave:

Rental 2:
Date Start:
Date End:
Owner:
Owner Phone:
Street Address:
City:
State:
Zip:
Reason/leave:

Employment Information

Current Employment (If none state so)
Date Start:		*
Date End:
Emp Name:		*
Title:		*
Supervisor:		*
Phone:		*
Address:
Salary:		*

Former Employment
Date Start:
Date End:
Emp Name:
Title:
Supervisor:
Phone:
Address:
Salary:

Personal References

Reference 1:
Name:
Relationship:
Phone:
Years known:

Reference 2:
Name:
Relationship:
Phone:
Years known:

Reference 3:
Name:
Relationship:
Phone:
Years known:

Reference 4:
Name:
Relationship:
Phone:
Years known:

Other Information

Automobile License Plate # :	State:
Automobile Make:		Model:
Description (color etc.):		Year:
Driver's License #:		State:
Have you ever been convicted of a felony?	*	If Yes, When?
Have you ever been convicted of a misdemeanor?	*	If Yes, When?
Have you ever filed for bankruptcy?	*	If Yes, When?
Have you ever been evicted?	*	If Yes, When?
Emergency Contact Person:		Phone:

Authorization to Process Application

Applicant represents that statements above made are true and correct and hereby authorizes verification of references to include, but not limited to credit checks, rental references, employment verifications unlawful detainer checks and agrees to furnish additional credit references on request, and waives any claim against any person(s) providing such verification. Applicants understand the Security Deposit must be paid within 24 hours of approval and is NON-REFUNDABLE if applicant does not choose to occupy the property.
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