For Office Use Only
Real Estate Leasing and Management Date: ________________________________
JCHiggins & Associates Property: D01
Property Managers Initials: _I.C_______ Unit #: ___________ Rent: _____________
Agent: Isela Cardenas Deposit:___________
Please complete all requested information on both pages. Thank you for your interest in our property.
Date of application: __________________ Desired Date of Occupancy: ______________________
PERSONAL INFORMATION
Full Name: _______________________________________________ Date of Birth: ___________________
Social Security Number: ______________________Driver License State & No. ________________________
Phone: _________________________________ Email:
_____________________________ _______________
Spouse’s Full Name: _______________________________________ Date of Birth: ____________________
Social Security Number: ______________________Driver License State & No. ________________________
Phone: _________________________________ Email: ________________________________________
Full Names of all others to occupy unit: Relationship to you: Date of Birth:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
How many pets do you or other occupants own?______ What type of pet? ____________________________
How did you hear about our property? _________________________________________________________
Do you speak any foreign languages fluently? _______ Which language? ____________________________
Do you have any additional sources of income? If so, please list ____________________________________
RESIDENCE HISTORY
Present Address: ______________________________________ City: _____________State: ___________
Zip: _______ Phone Number: ___________________ Date of Move-in: ___________________________
Present Landlord/Mortgage Company: __________________________ Phone Number: _______________
Monthly Payment: _____________________ Reason for Moving: _________________________________
Previous Address: _____________________________________ City: _____________State: ___________
Zip: ____ Phone Number: ___________________ Date of Move-in: ______ Move-out: ______________
Present Landlord/Mortgage Company: __________________________ Phone Number: ________________
Monthly Payment: _____________________ Reason for Moving: __________________________________
EMPLOYMENT HISTORY
Present Employer: _____________________________________ From: _________ To: _______________
Address: ______________________________________ City: _____________State: __________________
Zip: _______ Phone Number: ___________________ Position Held: ______________________________
FT/PT ____ Gross Monthly Salary: __________________
Previous Employer: ____________________________________ From: _________ To: ______________
Address: ______________________________________ City: _____________State: _________________
Zip: _______ Phone Number: ___________________ Position Held: _____________________________
FT/PT ____ Gross Monthly Salary: __________________
Spouse’s Present Employer: _____________________________ From: _________ To: ______________
Address: ______________________________________ City: _____________State: ________________
Zip: _______ Phone Number: __________________ Position Held: _____________________________
FT/PT ____ Gross Monthly Salary: __________________
OTHER INFORMATION
Please list all vehicles owned by you and all others to occupy unit
Year: ________ Make: ____________ Model: ____________ Color: _______ Plate No./State: _________
Year: ________ Make: ____________ Model: ____________ Color: _______ Plate No./State: _________
EMERGENCY CONTACT INFORMATION
Full Name: ______________________ Relationship to you: _______________ Phone Number: __________
Address: ______________________________ City: ____________ State: __________ Zip: ____________
Full Name: ______________________ Relationship to you: _______________ Phone Number: __________
Address: ______________________________ City: ____________ State: __________ Zip: ____________
DECLARATIONS
Applicant Co-Applicant
1. Are there any outstanding judgments against you? Y/N Y/N
2. Have you ever been convicted of a criminal offense? Y/N Y/N
3. Have you ever been evicted? Y/N Y/N
4. Have you ever received an unlawful detainer? Y/N Y/N
5. Have you declared bankruptcy within the past 7 years? Y/N Y/N
6. Do you owe any rental agencies/landlords money? Y/N Y/N
ACKNOWLEDGMENT AND NOTIFICATION TO APPLICANT
I understand I acquire no rights in any property until I sign this agreement and submit a holding fee in the form
of a cashier’s check or money order only, for the amount of the particular security deposit for that unit. If my
application is approved and I sign a Rental Agreement this holding fee shall be credited to my security deposit.
If my tenancy is approved but I DO NOT sign a Rental Agreement and move-in the holding fee shall be
forfeited to the owner as liquidated damages.
I understand I must pay a $50 NON-REFUNDABLE APPLICATION FEE (PER PERSON) for screening my
application made payable to JCHiggins & Associates. If this application is denied because of adverse credit
findings I may contact TRANSUNION at (800) 888-4213.
I/We hereby authorize JCHiggins & Associates to immediately obtain such credit reports, verifications of
income and of rental and employment histories and criminal background checks. I/We further understand that
false, fraudulent or misleading information disclosed above may constitute grounds for rejection of this
application, termination of rights of occupancy, and/or forfeiture of deposits/holding fee and may constitute a
criminal offense under the laws of this STATE.
We do not accept a comprehensive reusable tenant screening report.
Applicant: ________________________________ Co-Applicant: __________________________________
Date: ________________________________
Request for Verification of Rent
Do NOT fill out this form
For Office Use ONLY
Property Manager/Owner: _____________________________________ Fax: _______________________
This is a request for verification of Resident History. We are processing an application for residency and need to
complete our processing within 24 hrs. Your attention and response are necessary in order to expedite their
approval.
Name of Tenant: ________________________________________ Social Security#____________________
Property address: _______________________________________________ Unit #____________________
Please complete the following:
Move in date: ______________ Date of move out: ______________
Amount of rent:____________
Did tenant pay rent on time: Y N
Paid on time every month Late every month, but regular Not regular
Behind 1 or more months Not regular Behind 1 or more months
Grade the condition of the unit after move out: A__ B__ C__ D__ (A=Excellent)
Any Damages Y N Damages in the amount of $___________
Any complaints Y N If yes please explain_________________________
______________________________________________________________________________________________
Did Tenant give proper notice? Y N Did tenant have any pets? Y
Would you re-rent to this tenant? Y N
Verified By: ____________________________________________ Title: ____________________________
Date: _____________
Please complete and fax back to (253) 770-9568
Thank You,
Manager
Authorization:
I/We hereby authorize JCHiggins and Associates to immediately obtain such credit reports, verification of rental
history and employment history. I/We further understand that false, fraudulent or misleading information
disclosed above may constitute grounds for rejection of this application, termination of right of occupancy,
and/or forfeiture of deposits and may constitute a criminal offense under the laws of this STATE.
________________________________________________ ______________________
Applicant Signature Authorization Date
Request for Verification of Employment
Do NOT fill out this form
For Office Use Only
Employer: ___________________________________________ Fax: __________________________
This is a request for verification of employment. We are processing an application for residency and need to complete our
processing within 24 hrs. Your attention and response are necessary in order to expedite their approval.
Name of Employee: ____________________________________Social Security #________________
Please complete the following:
Position: __________________________________________Location: ________________________
Rate of pay: _______________________________________Date of hire: ______________________
Full time: ________ Part time: ________ Hours per Week: ______________
Verified By: ________________________________Title: __________________Date: ____________
If previous employee, please answer:
Date of separation: ___________ Would rehire Y_____N_____
Verified By: ______________________________________ Title: __________ Date: ________
Please complete and fax back to (253) 770-9568
Thank You,
Manager
Authorization:
I/We hereby authorize JCHiggins and Associates to immediately obtain such credit reports, verification of rental history
and employment history. I/We further understand that false, fraudulent or misleading information disclosed above may
constitute grounds for rejection of this application, termination of right of occupancy, and/or forfeiture of deposits and
may constitute criminal offense under the laws of this STATE.
____________________________________________ ___________________
Applicant Signature Authorization Date Signed