Rent Rexpro Realty Property Located at Beginning on Monthly Rate of $ Full Name * Date of Birth Phone Numbers * Email* Do you have a valid Social Security number? Make selection Yes No Do you have a valid Driver's License or Federal I.D.? Make selection Yes No Has your name ever been on a lease? Make selection Yes No Current Address City/State/Zipcode Reason for Moving or when does current Lease end? Current Monthly Rent Date moved in Previous Address City/State/Zipcode Date moved in & moved out Monthly Rent Paid Reason for Moving Employment information* Make selection Full time Part time Student Retired Unemployed Present Occupation Employers Name Position and Gross Monthly Income Employers Information Date employed from Other Sources of Income How many vehicles do you have? Do you have any work vehicles that will be parked on the property? If yes, please list how many and type of work vehicle. Who will be occupying the unit? How many Adults over the age of 18? How many children under the age of 18? Have you ever been sued for non-payment of rent? Make selection Yes No Have you ever been evicted, served with an eviction note or asked to move out? Make selection Yes No Have you ever been sued for damages to a rental property? Make selection Yes No Have you ever broken a rental agreement or lease? Make selection Yes No Have you ever declared bankruptcy? Make selection Yes No Do you have any pets? Make selection Yes No Type of Pet - Dog or Cat Breed of Dog (we do not allow any Pitbulls or Pitbull mixes) Spouse/Roommate/Partner Name(s) Spouse/Roommate/Partner - Employment Information Spouse/Roommate/Partner - How long on their job? Spouse/Roommate/Partner - Gross Monthly Income

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