Application Check-List
Click the box to "Check-Off" items that are needed and obtained for your application! All documents can be mailed, hand delievered or emailed to RRG using the button provided on the Potential Renterz Page, "Email Documents".
Applicant #1
*
First Name
Last Name
Birth Date
*
Enter in 01/01/2001 Format:
Main Phone Number
*
Country
(###)
###
####
Alternate Phone Number
Optional
Country
(###)
###
####
Applicant # 2
First Name
Last Name
Birth Date
Enter in 01/01/2001 Format:
Applicant # 3
First Name
Last Name
Birth Date
Enter in 01/01/2001 Format:
Applicant #4
First Name
Last Name
Birth Date
Enter in 01/01/2001 Format:
Do You Have a Pet?
Only Select Rentalz Allow Pets; Please choose Yes or No.
How many pets do you own?
Type of Pets
Add the type of pet(s), weight and the breed(s)... (If Applicable)
Residential History:
Present Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Previous Address #1
Where did you live before your current address?
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Previous Address #2
Optional
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Position:
Date Hired
MM
DD
YYYY
Supervisor's Name and Number:
(Enter Self or Full Name if Self-Employeed)
Salary and Pay Frequency
Enter your Salary, Hourly Pay or Rate of Compensation and Your Pay Frequency below:
Position
Date Hired
MM
DD
YYYY
Supervisor's Name and Number
Other Sources of Income
Do you receive income from any of the following sources?
Please check all that apply:
Other:
If "Other" was selected, please list and/or describe below:
Vehicle Information:
Please enter your vehicle information, as shown: (Year/Make/Model/ Plate Number); If multiple vehicles are owned, please list them as well.
Parking Stall Required?
Choose:
Banking Information:
Banking Institution Name, Address and Phone Number: (Enter as many as you have)
References:
Please enter 2 references below: (Name, Relationship to You and Phone Number)
Emergency Contact:
Please enter at least ONE Emergency Contact Below: (Name, Relationship to You and Phone Number)
Criminal Background Check:
Do you authorize Rent Roomz Genie to perform a Criminal Background Check?
Other:
Is there any criminal history that you would like to disclose and explain? If so, use the text box below to explain.
I declare that the information I have provided is accurate. I authorize the individual or organization to whom this application is submitted to: (a) contact my references and all other persons that I have named in this application; and (b) perform a credit and/or criminal check to assess my suitability as a tenant/lessee:
Applicant Signature:
Date
MM
DD
YYYY
Date
MM
DD
YYYY
