Wufoo

RENTAL APPLICATION

Sheena Petitt, R.A®., E-Pro® --Property Management & Sales Agent
KAUAI DREAMS REALTY
4-1435 Kuhio Hwy., Ste 202 Kapaa, HI 96746
PH: 808.822.5834 FAX: 808.822.5218 EMAIL: dreamrentals@hisemail.net

NOTICE TO APPLICANT: This application may be submitted to TenantCheck for verification.
Please furnish all information requested.

To submit your information in its entirety, please print out the rental application (FOUND ON OUR WEBSITE) and fax to us.

Screening services provided by UniCheck.
PERSONAL INFORMATION

SOCIAL SECURITY NUMBERS: (* For your protection, we will need your social security number submitted via phone or in a separate email.)
Applicant's Full Name First Last
Date of Birth: / MM / DD YYYY
Co-Applicant's Full Name First Last
Date of Birth: / MM / DD YYYY
Email *
Phone * - (###) - ### ####
OTHER RESIDENTS

Pet, children, other roommates:
List additional people living in unit: Names, age, relationship to you?
PETS: Cat, Dog, type, breed, age, indoor, outdoor?
RENTAL HISTORY
CURRENT ADDRESS: Street address, City, State, Zip
Landlord Name & Phone Number
Rent Paid:
Reason for moving?
For how long? Date (From-To)
PREVIOUS ADDRESS
Previous ADDRESS: Street address, City, State, Zip
Landlord Name & Phone Number
Rent Paid:
Reason for moving?
For how long? Date (From-To)
Supervisor
Telephone
EMPLOYMENT INFORMATION
Present Employer
ADDRESS: Street address, City, State, Zip
Date from:
To:
Supervisor
Telephone
PREVIOUS EMPLOYMENT INFORMATION
Previous Employer
ADDRESS: Street address, City, State, Zip
Date from:
To:
Supervisor
Telephone
CO APPLICANT EMPLOYMENT INFORMATION
Co-applicant's Employer
ADDRESS: Street address, City, State, Zip
Date from:
Postion
Gross Monthly Salary
If there are other sources of income you would like us to con sider, please list income, source and person (Banker, Employer, etc.) who we can contact for information. You do NOT have to reveal alimony, child support or spouse's annual income unless you want us to consider it in this application.
REFERENCES

Give us 2 references:
#1: Name First Last
Phone - (###) - ### ####
Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
#2. Name First Last
Phone - (###) - ### ####
Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
IN CASE OF EMERGENCY-NOTIFY:
Name First Last
Phone - (###) - ### ####
Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
VEHICHLE INFORMATION
Car Make/Model
Color
Year
Year
Other Motorcycle, Moped, etc
ADDITIONAL COMMENT:
If you're looking for a rental, be sure to tell us a little about yourself and your rental requirements (price range, number of bedrooms, bathrooms, pets, location on island, etc.).
I have Read the above form and I understand that if I cause a financial loss to my landlord that my name be placed on the files of both TenantCheck and UniCheck and such information will be furnished to subscribers who have a bonafide and legal need to make an inquiry. I also understand that causing a financial loss may limit my ability to obtain credit or lease other dwelling units. I hereby authorize consumer reporting agencies to provide you with consumer reports relating to me. I hereby give my permission for you and TenantCheck to verify the above information. * AGREE
Do Not Fill This Out

Wufoo

RENTAL APPLICATION

PERSONAL INFORMATION

OTHER RESIDENTS

RENTAL HISTORY

PREVIOUS ADDRESS

EMPLOYMENT INFORMATION

PREVIOUS EMPLOYMENT INFORMATION

CO APPLICANT EMPLOYMENT INFORMATION

REFERENCES

IN CASE OF EMERGENCY-NOTIFY:

VEHICHLE INFORMATION

ADDITIONAL COMMENT: