Renaissance Properties, LLC
117 South 5th Street, Richmond, IN 47374
Tel: (765) 966-4980 1-888-966-4980 Fax: (765) 965-7909
Rental Application Fees: $60 (apartment) and $75 (house and townhouse)
For Property Address:__________________________________________
Name:______________________________________
Home Phone:_______________
Work Phone:____________
SSN:_____________________________________
License No.:________________
DOB:_________________
Email Address:______________________________
Fax:______________________ Cell Phone:______________
Present Address:___________________________________
City : ______________________ State :________ Zip:_______
How long?:_______________ Rent:$____________
Reason for moving:__________________________________
Owner/Manager: ____________________________
Phone: __________________
Previous Address: ____________________________
City:______________________ State :________ Zip:_______
How long?:_______________ Rent:$____________
Reason for moving:__________________________________
Owner/Manager:____________________________
Phone:_____________________________
Name and relationship of every person to live with you
(include ages of minor children):
_______________________________________________________
_______________________________________________________
_______________________________________________________
_____________________________________________
Any pets?:_________
Describe:_________________________________________________
Water bed?:__________________________
Number of household members who
smoke:_________________________________________________
Present Occupation:___________________
Employer:_______________________
Phone:__________________
How long?:_________ Supervisor:_________________________
Phone:__________________
Employer's
Address:________________________________________________________
Employer's City:____________________________
State :_______________ Zip:__________
Previous
Occupation:___________________ Employer:_______________________
Phone:__________________
How long?:_________________________
Supervisor:______________________
Phone:__________________
Address:___________________________ City:______________________
State :__________ Zip:_______
Current Gross Income Per Month (before deductions):
$_______________________________________________
List other sources of income (other than present employment listed
above):____________________________________________________________
List other expenses (other than rent, car payments,
credit cards) example; child support payments:
___________________________________________________________________
Bank:_________________ Branch:___________
Major Credit Card:____________ Last 4 digits:_________
Renter's Insurance Co. :_____________________________
Policy #:_________________________
Have you ever filed for bankruptcy?:______________
Have you ever been evicted?:___________
Vehicle(s) Make:_____________________ Model:_______________
Year:_______ Plate #:__________________
Contact in case of emergency:__________________________________
Address:______________ Phone:___________ Relationship:_________
Spouse/Co-Applicant_:__________________________
Home Phone:________________ Work Phone: ____________
SSN:____________________________________
License No.:_________________ DOB:__________________
Email Address: _____________________________
Fax:_______________________ Cell Phone:______________
Present Address: _____________________________
City : ______________________ State :________ Zip:_______
How long?:_______________ Rent: $____________
Reason for moving:__________________________________
Owner/Manager: ____________________________
Phone: __________________
Previous Address: ____________________________
City : ______________________ State :________ Zip:_______
How long?:_______________ Rent: $____________
Reason for moving:__________________________________
Owner/Manager: ____________________________
Phone:_____________________________
Any pets?:_________
Describe:_______________________
Watered?:__________________________
Number of household members who
smoke:_________________________________________________
Present Occupation:___________________
Employer:_______________________
Phone:__________________
How long?:_________________________
Supervisor:______________________
Phone:__________________
Address:___________________________
City: _______ _____________________
State :________ Zip:__________
Previous Occupation:___________________
Employer:_______________________
Phone:__________________
How long?:_________________________
Supervisor:______________________
Phone:__________________
Address:___________________________
City: ____________________________
State :________ Zip:__________
Current Gross Income Per Month (before deductions):
$__________________________________________________
List other sources of income (other than present employment
listed above):__________________________________________________
List other expenses (other than rent, car payments,
credit cards) example; child support
payments:_______________________________________________________
Bank:_______________ Branch:________________
Major Credit Card:______________ Last 4 digits:_______
Renter's Insurance Co. :_____________________________
Policy #:_________________________
Have you ever filed for bankruptcy?:______________
Have you ever been evicted?:___________
Vehicle(s) Make:_____________________ Model:_______________
Year:_______ Plate #:__________________
Contact in case of emergency:________________
Address:________________ Phone:_______ Relationship:_________
I declare that the statements above are true and correct,and I
authorize verification of references and a credit check.
Signed:__________________________________________________
Date:______________________________
Co-Applicant:______________________________________________
Date:_______________________________
