Preliminary Rental Application

Please fill out all sections accurately and completely. A HOMES staff person will gladly assist you upon request.

I. Applicant Information
Applicant Name *
Applicant Name
Phone
Phone
II. Household Member Information: List all persons who will live in the unit beginning with the applicant.
III. Please provide all income/earning information for all household members.
IV. Personal References: Please provide the names & phone numbers of 1-2 persons in a position of authority and good standing in the community who could vouch for your personal character. These persons cannot be a family member or close personal friend.
Name
Name
Phone
Phone
Name
Name
Phone
Phone
V. Present & Previous Residence Information for the past 3 years.
Landlord Name
Landlord Name
Phone
Phone
Move-In Date
Move-In Date
Move-Out Date
Move-Out Date
Landlord Name
Landlord Name
Phone
Phone
Move-In Date
Move-In Date
Move-Out Date
Move-Out Date