404 East 4500 South, Suite #B22 - Murray, UT 84107

Office (801) 474-CASH

RENTAL CREDIT APPLICATION

Date:_______________________ Interviewed by:______________________________________

Name of Applicant: _____________________________________ Phone:______________________

Social Security Number: ______________________ Driver’s License #:________________________

Present Address: ___________________________________________________________________

City________________________________ State _______________ Zip______________________

Prior Address:_____________________________________________________________________

City________________________________ State _______________ Zip______________________

How long have you lived at present address? _______________________________________

Name of Landlord _____________________________________ Phone #:_____________________

Prior Landlord ________________________________________ Phone #: _____________________

How many will be living in this unit? Adult’s ___ Children ____ Pets____ Weight of Pets ___________

Employer: ___________________________________________ Position:_______________________

How long? __________________________________________ Phone #:_______________________

------------------------------------SPOUSE INFORMATION--------------------------------------------

Name_____________________________________________________________________________

Social Security Number: ______________________ Driver’s License #:________________________

Employer: ___________________________________________ Position: _______________________

How long? __________________________________________ Phone #:_______________________

Bank Name__________________________________ Phone #:______________________________

Address: ____________________________________________________________________________

Checking Account Number: _____________________ Savings Account Number:___________________

--------------------------------------------PERSONAL REFERENCES------------------------------------------

NAME RELATIONSHIP PHONE NUMBER

______________________________ __________________________ _____________________

______________________________ __________________________ _____________________

______________________________ __________________________ _____________________

------------------------------------------OTHER INFORMATION--------------------------------------------

Number of Vehicles (including company cars____________________________

Make/Model___________________________ Year _______ Color_________ Tag #_________ State____

Make/Model___________________________ Year _______ Color_________ Tag #_________ State____

Make/Model___________________________ Year _______ Color_________ Tag #_________ State____

HAVE YOU EVER

Filed for Bankruptcy ___ Yes ___ No If yes, When?_____________________________________

Been served an eviction notice or been asked to vacate a property you were renting? ___ Yes ___No

Willfully or intentionally refused to pay rent when due? ___ Yes ___ No If yes, When? ___________

How were you referred to us?

____________________________________________________________________________________

Rental Unit applied for: _________________________________________________________________

Commencement date: _______________ Term ______________ Rent/Month______________________

-----------------------------------------------DISCLOSURES------------------------------------------------

RADON GAS – Notice to Prospective Tenant: Radon is a naturally occurring radioactive gas that, when it has accumulated in a building
in sufficient quantities, may present risks to persons who are exposed to it over time. Levels of radon that exceed federal and state
guidelines have been found in buildings in every state. Additional information regarding radon and radon testing may be obtained at
you county public health unit.

LEAD PAINT – Every purchaser of interest in residential property on which a residential dwelling was built prior to 1978 us notified that
such property may present exposure to lead from lead-paint that may place young children at risk of developing lead poisoning. Lead
poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient,
behavioral problems and impaired memory. Lead poisoning also poses a particular risk to pregnant women. The seller of any interest
in residential real estate is required to provide the buyer with any information on lead-based paint hazards and risk assessments or
inspection in the seller’s possession and notify the buyer of any know lead-based paint hazards.
 ------------------------------------------ACKNOWLEDGEMENT-------------------------------------------

I/We the undersigned, declare that the foregoing information is true and correct, and I/We hereby authorize
you to conduct and employment check, credit check, and to verify our references.

______________________________________ ________________________________________
Applicant’s Signature Date Co-Applicant’s Signature Date

---------------------------------------------------------------------------------------------------------------------

FOR OFFICE USE ONLY – DO NOT WRITE BELOW

Application Verified Person Contacted Remarks

__Present Landlord ____________________ _______________________________

__Previous Landlord ____________________ _______________________________

__Applicant Employment ____________________ _______________________________

__Co-Applicants Employ. ____________________ _______________________________

__Bank ____________________ _______________________________

__Reference 1 ____________________ _______________________________

__Reference 2 ____________________ _______________________________

__Reference 3 ____________________ _______________________________

__Other ____________________ _______________________________

Verification completed by:_____________________________________________

Date: _____________________________________________________________

Remarks: __________________________________________________________

__________________________________________________________________

__________________________________________________________________

MONIES RECEIVED:

Date Description Amount

_______ ______________ ____________

_______ ______________ ____________

_______ ______________ ____________

THIS APPLICATION IS: ___ APPROVED ___ IS NOT APPROVED