Rental Application

REFERENCES & RENTAL APPLICATION

Instructions:
1) Fill in all blanks on form
2) Print the page
3) Sign in ink
4) Email a copy to cdalerental@gmail.com
- or -
4) Mail to: Kelly Thomas
808 E. Pleasant Hill
Carbondale, IL 62902

		Date
Your Name
Current Address
City
State		S.S. #
Zip		Drivers License
Current Phone		Date of Birth
Work Phone		eMail
Cell Phone

Roommates or Family Occupancy		List other occupants
Previous Address		occupants/pets...
Roommate Phone		Location you wish to rent
City
State		Preferred Occupancy Date
Zip		2nd choice

First Reference Current Landlord	Second Reference Relationship to You... Someone who is not a member of your immediate family, like your Mom.
Name:	Name:
Address:	Address:
Phone:	Phone:

I HEREBY GIVE PERMISSION TO Kelly Thomas OR STAFF
TO CHECK MY REFERENCES AND/OR CREDIT HISTORY.

Information obtained will be used only for the purpose of determining whether you qualify
for consideration as a tenant and will not be used for any other purpose.

SIGNATURE: ______________________________________________________ DATE: ______________
Sign in ink above AFTER printing

Office Use Only:

Credit Report Rating:	Reference 1		Reference 2
	Phone:	Letter:	Phone:	Letter:
Appt:	Rating:		Rating:

Lease Prepped:

Comments:

REFERENCES & RENTAL APPLICATION

First Reference

Second Reference

I HEREBY GIVE PERMISSION TO Kelly Thomas OR STAFF TO CHECK MY REFERENCES AND/OR CREDIT HISTORY.

I HEREBY GIVE PERMISSION TO Kelly Thomas OR STAFF
TO CHECK MY REFERENCES AND/OR CREDIT HISTORY.