APPLICATION FOR OCCUPANCY
Page 3 Document: February 2013

The pre-printed portion of this form has been drafted by the Arizona Association of REALTORS. Any change in the pre-printed language of this form must be made in a prominent manner. No representations are made as to the legal validity, adequacy and/or effects of any provision, including tax consequences thereof. If you desire legal, tax or other professional advice, please consult your attorney, tax advisor or professional consultant.
1. Address of Rental Property Applying for*
APPLICANT PERSONAL INFORMATION
NAME*
MARITAL STATUS*

SingleMarriedSeparatedDivorced
If divorced, date of decree
EMAIL ADDRESS:*
example@example.com
TELEPHONE*
SOCIAL SECURITY NUMBER*
DATE OF BIRTH*

MonthDay Year
Date
DRIVER'S LICENSE / GOVERNMENT ISSUED ID NUMBER*
STATE*
EXPIRATION DATE*

MonthDay Year
Date
DESIRED DATE OF OCCUPANCY*

MonthDay Year
Date
DESIRED LENGTH OF LEASE*
How did you hear about the property?*
EMPLOYMENT & BANK REFERENCES (Minimum one year verified employment required)
Current Employer*
Address*

Address
Street Address Line 2
City State
ZIP Code
12. Telephone*
How long?*
Start date*

MonthDay Year
Date
Department/Position*
Monthly Gross Income*
If you have been with your current employer less than one year, please complete the following:
Previous Employer
Address

Address
Street Address Line 2
City State
ZIP Code
17. Telephone
How long?
Date left

MonthDay Year
Date
Please provide a valid, enlarged copy of your current driver's license or government-issued photo ID and your 2 most recent paystubs or proof of income.v*

Photo ID and 2 most recent pay stubs
Cancelof
Bank*
Branch*
Telephone*
Account Number (checking)
Account Number (savings)
Other Income*
RESIDENCE HISTORY (Minimum one year required)
Current Rent/Mortgage Payment:*
*

RentOwn
How long?*
Current Address*
City*
State*
ZIP Code*
Landlord*
Telephone*
If owned, please provide the mortgage company name and address:
Mortgage Company
Telephone
Address
City
State
ZIP Code
If you have been at your current address less than one year, please complete the following:
Previous Address
City
State
ZIP Code
How Long?
Tax
PERSONAL REFERENCES
Name*
Relation*
Address*
Telephone*
Name*
Relation*
Address*
Telephone*
Name
Relation
Address
Telephone
DEPENDENTS/ADDITIONAL OCCUPANTS
Number of people who will occupy residence*
List occupants and their birthdates. CREDIT AND CRIMINAL BACKGROUND CHECKS WILL BE RUN ON EACH PERSON 18 & OVER.
Name
Relationship
D.O.B.
45. Name
Relationship
D.O.B.
Name
Relationship
D.O.B.
Name
Relationship
D.O.B.
Person(s) to notify in case of emergency and that you authorize to enter and take possession of your personal property in the event of death, pursuant to A.R.S. $33-1314(F), disability or incarceration:
Name*
Address*

52. Address
Street Address Line 2
City State
ZIP Code
53. Phone*
Email*
example@example.com
PETS/SERVICE ANIMALS
Will you have pets?*

YesNo
Breed
Age
Gender
Weight
57. Breed
Age
Gender
Weight
Recent photo of pet(s) required:

Cancelof
Will you have an assistive or service animal?*

YesNo
Accommodation request required with application

Cancelof
VEHICLE INFORMATION
59. Total Number of Vehicles (including company vehicles)*
Make
Model
Year
Color
Lic. Plate #
Make
Model
Year
Color
Lic. Plate #
Make
Model
Year
Color
Lic. Plate #
Description of any other vehicles (boat, trailer, truck, recreational vehicle, etc) you would like to keep on property. Prior written permission separate from this application must be obtained from management
CREDIT AND BACKGROUND HISTORY (ANSWER ALL QUESTIONS FOR YOURSELF AND FOR ANYONE WHO WILL OCCUPY THIS RESIDENCE)
Have you ever been evicted?*

YesNo
Has a notice of eviction ever been filed against you?*

YesNo
If so, when
Have you ever declared bankruptcy?*

YesNo
If so, when
Discharge Date

MonthDay Year
Date
Have you had two or more late rental payments in the past year?*

YesNo
Have you ever willfully or intentionally refused to pay rent when due?*

YesNo
Do you currently owe any monies to an apartment community or landlord?*

YesNo
Do you use illegal drugs?*

YesNo
Have you ever engaged in the distribution or sale of illegal drugs?*

YesNo
Have you ever been convicted, arrested or charged with any crime?*

YesNo
Please give a detailed explanation(s) date(s) and names for any question answered "Yes' above:
Do you have any outstanding warrants or anticipate any warrants for arrest?*

YesNo
ADDITIONAL INFORMATION
Have you or anyone in your household had, or do you presently have, bed bugs or other pest issues?*

YesNo
If yes, please explain
Please give any information that might help evaluate this application
DEPOSIT TO HOLD AGREEMENT
In consideration of management holding this property for me, agree to pay:
Earnest/holding deposit of a minimum of
A non-refundable application fee per person over 18 (certified funds only) of
The earnest/holding deposit is refundable if my application is not approved (14-day delay required for bank clearance of check If my Application is approved, the earnest/holding deposit is credited to the required move-in costs. IF APPLICANT SHOULD WITHDRAW THIS APPLICATION WITHIN 7 DAYS AFTER WRITTEN NOTIFICATION OF ACCEPTANCE a minimum of (fill below) of the earnest/holding deposit WILL BE RETAINED in addition to the non-refundable application fee. IF AFTER 7 DAYS OF NOTIFICATION OF ACCEPTANCE, APPLICANT WITHDRAWS OR FAILS TO EXECUTE LEASE AGREEMENT, ALL EARNEST/HOLDING DEPOSIT MONIES WILL BE FORFEITED. UNDER NO CONDITIONS WILL APPLICATION FEE BE REFUNDED.
Minimum of retained earnest money, prior to lease execution
Total deposits/fees submitted with application
95.NOTIFICATION OF ACCEPTANCE APPLICANT WITHDRAWS OR FAILS TO EXECUTE LEASE AGREEMENT ALL EARNEST/ HOLDING DEPOSIT MONIES WILL BE FORFEITED. UNDER NO CONDITIONS WILL APPLICATION FEE BE REFUNDED.

I hereby authorize and instruct Owner/Broker/Property Manager to investigate the information supplied by me and to conduct inquiries concerning my income, credit and character for the purpose of verifying and qualifying for this rental and any renewals thereof. I further authorize the release of any and all information available from any reference, former owners, and credit reporting services, department of motor vehicles, and governmental agencies. I hereby release and hold harmless all parties from liability for any damages that may result from furnishing this information to its owners, its agents and others. NOTE: Copy of actual credit report will not be provided to applicant by Owner/Broker/Property Manager.

Applicant acknowledges that Owner/Broker/Property Manager may not be able to complete a comprehensive evaluation of this information prior to move-in. Owner/Broker/Property Manager reserves the right to verify application information after move-in and may. convert the proposed Lease Agreement to a month-to-month term or declare the lease irreparably breached and seek immediate eviction if false or misleading information is contained in this Application. Applicant agrees to the terms of this Deposit to Hold Agreement. This application is preliminary only and does not obligate owner or owner's representatives to execute a lease or deliver possession of the proposed Property. Owner/Broker/Property Manager comply with federal, state and local fair housing laws and regulations.

Unless otherwise agreed, I understand that the Brokerage, its Broker, its Agents, and employees are agents of and represent the Owner in leasing this property.
Applicant's Initials Required*
By signing below. I acknowledge and accept the qualifying criteria and policies of the Owner/Broker/Property Manager by which my application will be approved. This application must be signed by applicant.
Applicant Signature Required*

Clear
MO/DA/YR*
Date of Signature
FALSIFYING INFORMATION ON THIS APPLICATION IS GROUNDS FOR REJECTION.

For final approval, a credit and background check will be sent by the landlord to the applicant at the applicant's expense via mysmartmove.com.
Should be Empty:

Arizona Luxury Partners - Lease Application

APPLICATION FOR OCCUPANCY

APPLICANT PERSONAL INFORMATION

PERSONAL REFERENCES

DEPENDENTS/ADDITIONAL OCCUPANTS

PETS/SERVICE ANIMALS

VEHICLE INFORMATION

CREDIT AND BACKGROUND HISTORY (ANSWER ALL QUESTIONS FOR YOURSELF AND FOR ANYONE WHO WILL OCCUPY THIS RESIDENCE)

ADDITIONAL INFORMATION

DEPOSIT TO HOLD AGREEMENT

Ready to get started?