VIRGINIA ASSOCIATION OF REALTORS@ APPLICATION FOR RESIDENTIAL LEASE (This is a legally binding contract. lf not understood, seek competent advice before signing') The property will be shown and made available to all persons without regard to any protected class under federal, state or local fair housing law or regulations, or the REALTOR@ Code of Ethics' This Application for Residential Lease (the "Application") is made as ot by and between A EOUAL HOUSING OPPORTUNITY ("Applicant") and ("Landlord") through Hess & Mi11er Inc. ('Listing Broker" or "Agent", who represents Landlord), and Hess & Mil]-er Inc' ("Leasing Broker", who does E OR does not E represent Applirant- lf Listing Broker is engaging rn dual or designated agency, a separate consent agreement has been entered into by Listing Broker and APP|icant. Applicant hereby applies for a residential dwelling unit (the "Dwelling Unit") located at Virginia, in the City/CountY of , for occupancy commenclng on at an initial monthly rent payment oI Dollars ($ Dwelling Unit must complete this Application. PLEASE FILL IN ALL INFORMATION COMPLETELY 1. Applicantlnformation. ). All persons over the age of 18 who will reside in the Applicant #1 Applicani #2 Applicant #3 Name SSN/ITIN Date of Birth Home # Work # Cell Phone # Email Address Present Address Rental Amount Years Landlord Landlord Address Landlord Phone Previous Address Rental Amount Years Landlord 1of 8 VAR FOBM 300 Revised 07/16 Reviewed 07/15 Hess & Miller lnc.. 234 E Market st. Harisonburg. vA 2280 I Phone: 5'10-'{34-7181 }rax: 5'lo-',+3'l-4113 Rental application Rick Manz produced with zipForm@ by ziplogix '1 8070 Fifteen Mile Road, Fraser, Michrgan 48026 \M zrDloolx.com
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VIRGINIA ASSOCIATION OF REALTORS@APPLICATION FOR RESIDENTIAL LEASE
(This is a legally binding contract. lf not understood, seek competent advice before signing')
The property will be shown and made available to all persons without regard to any protected class under federal, state or local fair
housing law or regulations, or the REALTOR@ Code of Ethics'
This Application for Residential Lease (the "Application") is made as ot by and between
AEOUAL HOUSING
OPPORTUNITY
("Applicant") and
("Landlord") through Hess & Mi11er Inc. ('Listing Broker" or "Agent", who represents
Landlord), and Hess & Mil]-er Inc' ("Leasing Broker", who does E OR does not Erepresent Applirant- lf Listing Broker is engaging rn dual or designated agency, a separate consent agreement has been entered into
by Listing Broker and APP|icant.
Applicant hereby applies for a residential dwelling unit (the "Dwelling Unit") located at
Virginia, in the City/CountY of , for occupancy commenclng on
at an initial monthly rent payment oIDollars ($
Dwelling Unit must complete this Application.
PLEASE FILL IN ALL INFORMATION COMPLETELY
1. Applicantlnformation.
). All persons over the age of 18 who will reside in the
Applicant #1 Applicani #2 Applicant #3
Name
SSN/ITIN
Date of Birth
Home #
Work #
Cell Phone #
Email Address
Present Address
Rental Amount
Years
Landlord
Landlord Address
Landlord Phone
Previous Address
Rental Amount
Years
Landlord
1of 8
VAR FOBM 300 Revised 07/16Reviewed 07/15Hess & Miller lnc.. 234 E Market st. Harisonburg. vA 2280 I Phone: 5'10-'{34-7181 }rax: 5'lo-',+3'l-4113 Rental application
Rick Manz produced with zipForm@ by ziplogix '1 8070 Fifteen Mile Road, Fraser, Michrgan 48026 \M zrDloolx.com
Applicant #1 Applicant #2 Applicant #3
Landlord Address
Landlord Phone
Presently EmploYed BY
How long?
Position
Salary (Wk., Mo., Yr.) $ $ s
Supervisor
Telephone
Formerly Employed BY
How long?
Supervisor
Other Occupants:Name/Age/RelationshiP
Email Address
Apolicant #1 Applicant #2 Applicant #3
Number of Vehicles
Make
Model
License #
2. Vehicle lnlormation:
3. Animals:
2ot8VAR FORM 300 Revised 07/16Reviewed 07/16
produced with zipForm@ by ziplogix 18070 Fifteen tvite Road, Fraser, lvlichigan 48026 M.zipLooix.com Rental application
Animal #1 Animal #2 Animal #3
Name of Animal
Type
Breed
Color
Weight
4. lf you are presently in the Armed Services, state:
Apolicant #1 Applicant #2 Applicant #3
Branch
Rank
Outfit
Telephone
Applicant #l
5. Other lncome You Would Like Landlord to Consider: