| EMPLOYMENT INFORMATION | |||
| EMPLOYER |
PHONE | ADDRESS | |
| POSITION |
SUPERVISOR | LENGTH OF EMPLOYMENT | |
| PREVIOUS EMPLOYER |
PHONE | ADDRESS | |
| POSITION |
SUPERVISOR | LENGTH OF EMPLOYMENT | |
| CURRENT GROSS INCOME |
OTHER INCOME | ASSETS | |
| CREDIT INFORMATION | |||
| NAME OF BANK |
BRANCH OR ADDRESS | ACCOUNT# | CHECKING OR SAVINGS |
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| MONTHLY BILLS | |||
| NAME OF CREDITOR |
ADDRESS | PHONE NUMBER | MONTHLY PAYMENT |
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| LIST ANY OTHER DEBTS |
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| In the past 5 years have you or any person named on this application been convicted for dealing or manufacturing illegal drugs?_________ Applicant testifies all of the above is true and correct and hereby authorizes verification including, but not limited to the obtaining of a credit report, criminal background check, verification of employment and current and past residence. Applicant further agrees to furnish additional credit references if requested. The undersigned makes application to rent housing accomodations from Safire Limited, LLC. If accepted and upon signing a rental agreement, Applicant agrees to pay all sums due, including required security deposits prior to occupancy. APPLICANT__________________________________________DATE________ APPLICANT__________________________________________DATE________
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