Online Rental Application

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Date:

Unit interested in:

Price advertised:

How did you hear about this unit?

If online what site?

Do you have any pets?

If yes list qty, wgt, breed

Security deposit & first month rent

Have enough funds to pay on own
Applying for assistance

Applying for assistance from:

Move by date:

Applicant Information

Name (Last,First,M):

Birthdate:

Social Security #

Telephone #:

Alternate Number:

Email:

Co-Applicant Information

Name (Last,First,M):

Birthdate:

Social Security #:

Telephone #:

Alternate Number:

Email:

Other Occupants

Occupant Name:

Age:

Social Security #:

Email / Alternate #:

Occupant Name:

Age:

Social Security #:

Email / Alternate #:

Occupant Name:

Age:

Social Security #:

Email / Alternate #:

Occupant Name:

Age:

Social Security #:

Email / Alternate #:

Total Adults:

Total Children:

Housing Data

Present Address:

City:

State:

Zip Code:

From Date:

Landlord's Name:

Telephone:

Rent:

Why are you moving?

Previous Address:

City:

State:

Zip Code:

Date From:

Date To:

Landlord's Name:

Telephone:

Rent Paid:

Why did you move?

Employment

Applicant

Employer:

Position Held:

Address:

Office Number:

Dates Employed:

Schedule:

Full-time
Part-time

Wages/Salary:

Supervisor Name:

Phone#:

Previous Employer:

Phone#:

Supervisor Name:

Schedule:

Full-time
Part-time

Dates Employed:

Position:

Salary/Wage:

Co-Applicant Employment

Co-Applicant Employer:

Phone#:

Supervisor:

Schedule:

Full-time
Part-time

Dates Employed:

Position:

Salary/Wage:

Other Income

Source:

Worker's Name:

Amount:

Frequency:

Unit/Branch:

Telephone:

Bank Data

Bank Name:

Savings Account last 4 digits:

Checking Account last 4 digits:

Direct Deposit?

Yes
No

Bank Name:

Savings Account last 4 digits:

Checking Account last 4 digits:

Direct Deposit:

Yes
No

Personal References

Nearest relative name:

Telephone:

Address:

Relationship:

1. Personal Reference Name:

Telephone:

2. Personal Reference Name:

Telephone:

In case of emergency notify:

Address:

Phone#:

Relationship:

I have read the above form and I understand that if I cause a financial loss to my landlord, that my name may be placed in the files of both RM Management LLC and Equifax and such information will be furnished to subscribers who have a bonafide and legal need to make an inquiry. I also understand that causing a financial loss may limit my ability to obtain credit or lease other dwelling units. If my application is denied, I may, within 30 days of such notification, request a written statement of reason(s) by contacting RM Management LLC at the address shown above.

I hereby authorize consumer reporting agencies to provide you with consumer reports relating to me. I hereby give my permission for RM Management LLC and Equifax to verify the above information and I understand that should you have to call the mainland or the other islands for such verification that I will be charged the cost of the call.

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FOR RENT : Alii Manor - 2 bedroom 1 bath 1 parking $1200
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