Online Single person rental application

Stephen J. Neville, Licensed Real Estate Broker, d.b.a.,
Aamerican Property Management (Agent For Owner)
Cell: 321/693-8026 - Call Message Center/Home Office Fax: 321/724-5380
Email: nevillesj@earthlink.net- 144 Ocean Terrace, Indialantic, FL 32903
SINGLE Rental Application (Authorization for Credit/Background Checks)
*SPECIFIC PET INFORMATION IS ALSO A FORFEITURE ISSUE – Each application must include all occupants and all pets
Rental Property: ___________________________________________________________________ Monthly Rent: $________.00
Name: ________________________________________________________ Date of Birth ____/_____/________
SS#: ______-________-____________DL#; ___________________________________DL State: ___ Copies Incl: YES NO
*Have you ever had a/an (insert Yes or No): Felony conviction or charges ___; Alias ___; Eviction or been served papers___;
Charge-off ___; Collection ___; Delinquency ___; Bankruptcy ____: Failed To Pay Rent ____; Failed To Honor Lease ____
Current Address: _________________________________________________________________________________________
*All Additional Occupants: NAME: ___________________ RELATIONSHIP: _____________________18 or older YES NO
*All Additional Occupants: NAME: ___________________ RELATIONSHIP: _____________________18 or older YES NO
*All Additional Occupants: NAME: ___________________ RELATIONSHIP: _____________________18 or older YES NO
Phone, Work ____/____-_____, Home ____/____-_____ Cell: ____/____-_____ Email: ______________@_____________._____
Vehicle #1 make ________________ Model ______________ Color _____________Tag Number ________________ State _____
Vehicle #2 make ________________ Model ______________ Color _____________Tag Number ________________ State _____
Pet: __________ Breed _________________ Size ____lbs. AGE: _____ COLOR: _____Vet ID Copies Incl: YES NO
Pet: __________ Breed _________________ Size ____lbs. AGE: _____ COLOR: _____Vet ID Copies Incl: YES NO
Monthly Rent $ ________ Month & Year move in _______/____________ out _______/____________ Lived there ______ years
Reason for leaving __________________________________________________________________________________________
Owner/Landlord/Agent ___________________ Contact phone number ________________ Alternate number _________________
Monthly Rent $ ________ Month & Year move in ________ out _________ Reason for leaving _____________________________
Your 6 month employment information: Full-Time , Self-Employed , Student , Retired , Other __________________
Employer ___________________________ Address ____________________________________________________________
Position __________________________ Supervisor ________________________ Supervisor’s Phone ____________________
Salary/Wage $ _________ per ____________ Start Date _____________ Previous employer on back if less than 6 months or 2nd job.
In case of emergency notify: _________________________ Phone ___________________ Where _________________________
Applicant(s) represents that all of the above information and statements on this application for rental are true and complete, and
applicant(s) hereby authorizes verification of any and all information relating to residential history (rental or mortgage), employment
history, criminal history records, court records, and credit references. This application must be signed before management can
process it. *Applicant(s) acknowledges that false or omitted information herein does constitute grounds for rejection of this
application, termination of Right of Occupancy, and will result in forfeiture of fees and/or deposits to Aamerican Property
Management and may constitute a criminal offence under the Laws of the State of Florida.
Applicant(s) understands that he/she is being charged a NON-REFUNDABLE application fee of $40.00 for primary applicant and
each additional person 18 years of age or older – This application is part of the rental application process and does in no way obligate
the OWNER or the AGENT FOR THE OWNER to execute a lease/rental agreement or deliver possession of the proposed premises.
Associations may require a separate application process and fee. No oral agreements have been made. We are pleased to comply with
Federal Fair Housing Laws, State Real Estate Laws, ADA Regulations, FS 83, etc. and incorporate them in our method of operation.
*I agree that the Owner/Agent for Owner may terminate any agreement entered into in reliance on any misstatement(s) made
above, and, further agree that upon such misstatement Agent for Owner may retain all fees and deposits.
Witness _____________________ Applicant _______________________________________________ DATE: ____/_____/2007
Where room does not permit, please ad information to reverse side, sign and date – Thank you!