​​​​​​​​​​American Home Realty Group 

American Home Realty Group

275 S Charles Richard Beall Blvd STE 214 Debary, FL 32713• 386-668-9188 PH   386-662-0545 Fax

Rental/Credit Application

we make real estate real!

 

   

CONSUMER REPORT DISCLOSURE AND AUTHORIZATION

 

 

I hereby affirm that my answers on this application to lease are true and correct and that I have not knowingly withheld any fact or circumstance which would, if disclosed, affect my application unfavorably. I authorize American Home Realty Group to secure from Alpha & Omega Human Resource Solutions, LLC a consumer-reporting agency, a consumer report and/or investigative consumer report. This report may contain, but is not be limited to, criminal court records, civil court records, sex offender registry records and verification of my residences, employment and income.

 

I further authorize you to secure a consumer report and/or investigative consumer report at any time, and any number of times, before, during and after my lease, if in your discretion, you have a legally permissible and a legitimate business need for the information requested.

 

 I authorize Alpha & Omega Human Resource Solutions, LLC to verify any and all information contained in this application and to inquire into my character, general reputation, personal characteristics and mode of living, and I release all concerned from any liability in connection with any information they give. I have also been advised that I have the right, under the federal Fair Credit Reporting Act (FCRA), Section

 

 606(B) to make a written request of you and Alpha & Omega Human Resource Solutions, LLC , within a reasonable time, for a complete and accurate disclosure of the nature and scope of the investigation.

 

 

Signature: _________________________________________________ Date:_______________

 

Signature: _________________________________________________ Date: _______________

 

 Witness: __________________________________________________ Date: _______________


Personal Information:

 
Date:____________________  Interviewed by:_____________________________________________

Name of Applicant:____________________________________  Date of Birth:___________________

E-Mail:___________________________________________   Telephone No.:____________________

Social Sec. No.:_______________________________  Drivers License No.:______________________

Present Address:______________________________________________________________________

City:_____________________________________  State:_______________ Zip:__________________

How long have you lived at present address? ______________________________________________  

​Present Landlord:___________________________________  Telephone No.:______________________

Prior Address:____________________________________________________________________

City:_____________________________________  State:_______________ Zip:__________________

How long have you lived at prior address? ________________________________________________



How many will be living in this unit?  Adults:____________  Children:____________  Pets:_________

Employer_________________________________________  Occupation:_______________________

Current Salary:__________________________  How long?__________________________________

Contact Person:____________________________  Telephone No:_____________________________

***Please include your last 3 Pay Stubs or your last 2 years of Tax Returns if Self Employed***


 


Spouse Information:

Name of Spouse:___________________________  Date of Birth:_____________________________

Email:_____________________________________  Telephone No:____________________________

Social Sec No:______________________________  Drivers License No:__________________________

Employer:______________________________________   Occupation:___________________________

Current Salary: _____________________   How Long? _______________________________

Contact Person:_________________________________________

 

***Please include your last 3 Pay Stubs or your last 2 years of Tax Returns if Self Employed***


Children Information:


Name: ____________________________  Age: ____  Birth Date: ______________  Gender: ___________

Name: ____________________________  Age: ____  Birth Date: ______________  Gender: ___________

Name: ____________________________  Age: ____  Birth Date: ______________  Gender: ___________

Name: ____________________________  Age: ____  Birth Date: ______________  Gender: ___________

Name: ____________________________  Age: ____  Birth Date: ______________  Gender: ___________


Personal / Credit Reference:


Name: _________________________ Relationship: ____________________ Phone No: _______________

Name: _________________________ Relationship: ____________________ Phone No: _______________

Name: _________________________ Relationship: ____________________ Phone No: _______________



Other Information:


Number of Vehicles (including company vehicles): _______________________________________


Make / Model ______________  Year: _______ Color: ______________ Tag No. __________ State: ______ 

Make / Model ______________  Year: _______ Color: ______________ Tag No. __________ State: ______

Make / Model ______________  Year: _______ Color: ______________ Tag No. __________ State: ______

Make / Model ______________  Year: _______ Color: ______________ Tag No. __________ State: ______


Have you Ever?

Filed for Bankruptcy?   (  ) Yes    (  ) No  If Yes, When:

Been Served an eviction notice or been asked to vacate a property you were renting? (  ) Yes    (  ) No

Willfully or intentionally refused to pay rent when due?  (  ) Yes    (  ) No

Been Sued for unlawful detainer? (  ) Yes    (  ) No

Have you ever been arrested or convicted of any illegal activity (other than minor traffic)  (  ) Yes    (  ) No


If Yes, Please explain: __________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________


*****************************************************************************************************************

APPLICANT ​represents that all the statements and representations are true and complete, and hereby, authorizes verification of the above information, references and credit records. APPLICANT understands that an investigative consumer report including information about character, credit history, general information including criminal records many be made. APPLICANT agrees that false,misleading or misrepresented information will result in the application being rejected, will void a lease/rental agreement if any and/or be grounds for immediate eviction with loss of all deposits and any other penalties as provided by the terms if any. APPLICANT authorizes verification of all information by the Landlord and / or Management Company.


NON REFUNDABLE APPLICATION FEE: APPLICANT shall pay Landlord and / or Management Company the sum of $55.00 per adult as a NON REFUNDABLE CREDIT REPORT FEE for costs and processing the application. 



GOOD FAITH DEPOSIT: APPLICANT shall deposit a GOOD FAITH DEPOSIT of $100.00 with Landlord or Management while the application is being processed. APPLICANT understands that other applications many be processed and another approved APPLICANT many be chosen. If APPLICANT ​is approved by Landlord and / or Management Company and the lease is entered into, the GOOD FAITH DEPOSIT shall be applied toward Security Deposit. If ​APPLICANT is approved and chosen, but fails to sign the lease within 3 days of verbal and/or written approval and / or take possession after lease signing, the FULL GOOD FAITH DEPOSIT amount shall be forfeited to the Landlord and / or Management Company in addition to any penalties as provided in the lease if the lease has been signed by the APPLICANT. The GOOD FAITH DEPOSIT shall be refunded only if APPLICANT is not approved and chosen. Keys will be furnished only after lease and other rental documents have been properly executed by all parties and only after applicable rent, fees, deposits and security deposits have been paid and all requirements of Landlord and / or Management have been met including but not limited to APPLICANT providing proof that all utilities have need placed in APPLICANT'S name. The application is preliminary only, in no way implies that a particular rental unit shall be available and in no way obligates Landlord and / or Management to execute a lease or deliver possession of the proposed premises to the APPLICANT even if approved.





Signature: _____________________________________





Signature: _____________________________________ 





Rental Unit Applies For: _____________________________________





Commencement Date
: ______________________________________  Rent/Month: _____________