PLEASE RETURN COMPLETED APPLICATIONS TO:

Kirk Walters
P.O. Box 137
North Liberty, IA 52317
Or fax to (319) 626-4542
*Note: If you have additional information, please use a separate sheet of paper and attach to this form.
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Apartments by Walters
RENTAL APPLICATION                                        EACH PERSON MUST FILL OUT AN APPLICATION

DESIRED MOVING DATE _________________________________________________________

How you heard of us ____ Newspaper ____ Sign ____ Friend ____ Web _____ Other __________

FULL NAME __________________________________________ BIRTH DATE ______________

PHONE NUMBERS  _____________________•_____________________•__________________
                home                                     work                                  cell

SOCIAL SECURITY #  ______________  DRIVER’S LICENSE #  _____________  STATE  ______

PEOPLE TO LIVE WITH YOU

1.  _________________________________________________________________________
full name                                 relationship                                 age

2.  _________________________________________________________________________    
full name                                 relationship                                 age

DO YOU HAVE PETS? ______  IF SO, DESCRIBE  _____________________________________

DO YOU HAVE A WATER BED? ________ DO YOU SMOKE?  _________

DO YOU HAVE RENTER’S INSURANCE?  ________  INSURANCE COMPANY ________________

PRESENT ADDRESS  ____________________________________________________________

NAME(S) ON LEASE _____________________________________________________________

RENT $ _________ / month    FROM  ______________________   TO _____________________

REASON FOR MOVING __________________________________________________________

OWNER/MANAGER ________________________________________  PHONE  #____________

PREVIOUS ADDRESS ___________________________________________________________

NAME(S) ON LEASE  ____________________________________________________________

RENT $ _________ / month    FROM  _______________________  TO ____________________

REASON FOR MOVING __________________________________________________________

OWNER/MANAGER ___________________________________________  PHONE #__________

PRESENT OCCUPATION __________________________________________________________

EMPLOYER AND LOCATION ____________________________________ PHONE #__________

SUPERVISOR’S NAME _________________________________________ PHONE #__________

DATES WORKED  FROM  ________________________ TO _____________________________

PREVIOUS OCCUPATION _________________________________________________________

EMPLOYER AND LOCATION ____________________________________  PHONE # _________

SUPERVISOR’S NAME _________________________________________  PHONE # _________

DATES WORKED  FROM ________________________   TO _____________________________

CURRENT GROSS INCOME PER MONTH (before deductions) $ ___________________________

OTHER SOURCES OF INCOME $ _________  per _____ OR ASSISTANCE $ ________ per_____

ARE YOU A STUDENT? _______ SCHOOL NAME _____________________________________

LIST SOURCES OF ASSISTANCE __________________________________________________

AMOUNT YOU RECEIVE $ ___________

AMOUNT OF CHILD SUPPORT/ALIMONY YOU PAY  $ ____________    RECEIVE  $ __________

CHECKING ACCOUNT BANK

_____________________________________________________________________________
name                                         city                                        state

SAVINGS ACCOUNT BANK

_____________________________________________________________________________
name                                        city                                         state

MAJOR CREDIT CARD ___________________ BALANCE OWED _________ PAYMENT_______

CREDIT REFERENCE ___________________________________________________________

HAVE YOU EVER FILED FOR BANKRUPTCY? ______ HAVE YOU EVER BEEN EVICTED?  _____

TOTAL NUMBER OF VEHICLE(S) _____________ * NOTE: Only 2 vehicles per apartment allowed.

_____________________________________________________________________________
make                model                year        color                license plate #                        state

_____________________________________________________________________________
make                model                year        color                license plate #                        state

PERSONAL REFERENCE

_____________________________________________________________________________
name                                  phone #                            address

CONTACT IN EMERGENCY

_____________________________________________________________________________
name                                  phone #                            address

Have you been or are you presently an illegal user of a controlled substance?  ________________

I declare that the above statements are true and correct, and I hereby authorize verification of
given references and a credit check
.


X ____________________________________________________________________________
signature                                                                            date
Apartments for Rent Coralville Iowa
Apartment rental Coralville IA, near rental apartments Iowa City, Iowa.