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Online Rental/Leasing Application

Personal Information

Applicants First Name*

Applicants Last Name*

Applicants SSN*

Applicants Date of Birth*

Applicants E-Mail*

Applicants Drivers License Number*

Issue State*

Applicants Address*

Applicants City*

Applicants State*

Applicants Zip*

Applicants Primary Phone*

Employment Information

Employers Name*

Position*

Supervisor*

Employers Phone Number*

Employers Address*

Additional Income Sources

Additional Income Source

Monthly Amount

Residential History

Previous Address*

Previous City*

Previous State*

Manager Name

Manager Phone

How Long (Years)*

Credit References

Credit Reference Name*

Credit References Address*

Credit References City*

Credit References State*

Credit References Phone Number*

Credit References Acct No*

Credit References Payments*

Credit Reference 2 (If applicable)

Secondary Credit References Name

Secondary Credit References Address

Secondary Credit References City

Secondary Credit References State

Secondary Credit References Phone Number

Secondary Credit References Acct No

Secondary Credit References Payments

Other Information

Vehicle Make/Model

License Plate Number

Emergency Contact

Emergency Contacts Name*

Emergency Contacts Relationship*

Emergency Contacts Address*

Emergency Contacts City*

Emergency Contacts State*

Emergency Contacts Zip*

Emergency Contacts Phone Number*

By Checking this box you agree to consent to MSPM, itself or through its designated agents or employees, to obtain a consumer credit report and/or criminal record information on each of us and to obtain and verify each of our credit and employment information for the purpose of determining whether to lease an apartment to me/us. We also agree and understand that MSPM and its agents and employees may obtain additional consumer credit reports on each of us in the future to update or review our account and lease. Upon request, MSPM will tell me/us whether consumer reports were requested and the names and addresses of any consumer credit reporting agency that provided such reports.

I Agree

All properties managed by Mountain States Property Management, Inc (MSPM) comply with State and Federal Fair Housing Guidelines.