169 Jefferson Drive, Mastic Beach, NY 11951
RENTAL APPLICATION - 169 JEFFERSON DRIVE, MASTIC BEACH NY 11951
http://169jeffersondrive.weebly.com/
Cozy Cape Cod House, $1275 mo., fire place, ¼ acre fenced lot, 2 br, 1bath, kitchen, dining room, living room, basement, washer /dryer, finished attic, 600 sq.ft., windows and light from N/S/E/W; part furnished very clean; no smoking; no pets; 3 persons max.; deposit, references, credit check required.
The first step in applying to rent the house is to complete the attached application and to return it by email. Send completed application form to [email protected]
Avoid Fraud and Scams: Send no money until you have seen the inside of the house and met the owner in person.
An application form (see below) must be completed by all occupants 18 years or older. Send completed application form to [email protected]
AN APPOINTMENT TO VIEW THE HOUSE WILL BE SCHEDULED AFTER RECEIPT OF COMPLETED APPLICATION FORM.
TODAY’S DATE:
I hereby apply to rent/lease the property at: 169 Jefferson Drive, Mastic Beach NY 11951
Term of rental: one year
Monthly rent: $1275
Security Deposit: $1275
GENERAL:
List all proposed adult occupants:
Name Date of Birth
Name Date of Birth
Name Date of Birth
List all minors or persons who will visit on a permanent basis:
Name Date of Birth
Name Date of Birth
OCCUPANT 1:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 1 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 1 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 1 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 1 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 1 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 1 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 1
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
OCCUPANT 2:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 2 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 2 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 2 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 2 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 1 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 2 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 2:
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
OCCUPANT 2:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 2 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 2 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 2 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 2 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 2 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 2 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 2:
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
Applicants Names:
OCCUPANT 3:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 3 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 3 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 3 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 3 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 3 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 3 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 3:
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
http://169jeffersondrive.weebly.com/
Cozy Cape Cod House, $1275 mo., fire place, ¼ acre fenced lot, 2 br, 1bath, kitchen, dining room, living room, basement, washer /dryer, finished attic, 600 sq.ft., windows and light from N/S/E/W; part furnished very clean; no smoking; no pets; 3 persons max.; deposit, references, credit check required.
The first step in applying to rent the house is to complete the attached application and to return it by email. Send completed application form to [email protected]
Avoid Fraud and Scams: Send no money until you have seen the inside of the house and met the owner in person.
An application form (see below) must be completed by all occupants 18 years or older. Send completed application form to [email protected]
AN APPOINTMENT TO VIEW THE HOUSE WILL BE SCHEDULED AFTER RECEIPT OF COMPLETED APPLICATION FORM.
TODAY’S DATE:
I hereby apply to rent/lease the property at: 169 Jefferson Drive, Mastic Beach NY 11951
Term of rental: one year
Monthly rent: $1275
Security Deposit: $1275
GENERAL:
List all proposed adult occupants:
Name Date of Birth
Name Date of Birth
Name Date of Birth
List all minors or persons who will visit on a permanent basis:
Name Date of Birth
Name Date of Birth
OCCUPANT 1:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 1 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 1 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 1 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 1 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 1 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 1 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 1
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
OCCUPANT 2:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 2 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 2 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 2 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 2 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 1 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 2 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 2:
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
OCCUPANT 2:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 2 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 2 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 2 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 2 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 2 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 2 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 2:
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
Applicants Names:
OCCUPANT 3:
Personal Info:
Last name:
First Name:
Middle initial:
Social Security number:
Birth date:
Drivers License #:
State:
Address and zipcode on license:
Email:
Cell Phone Number:
OCCUPANT 3 Vehicles:
Type:
Color:
Make:
License Plate #:
State:
Year:
OCCUPANT 3 EMPLOYMENT HISTORY:
Current Employment:
Position:
How long you have been working here:
Employer’s name:
Employer’s phone number:
Street address:
City:
State:
Zipcode:
Current salary:
Monthly
Annually
OCCUPANT 3 EMPLOYMENT HISTORY:
Past Employment:
Position:
How long you have worked there:
Employer’s name:
Employer’s phone number:
Employer’s address:
Street address:
City:
State:
Zipcode:
Salary:
Monthly:
Annually:
OCCUPANT 3 Rental history:
Current home Address:
Street address:
City:
State:
Zipcode:
How long have you been at this address?
Manager’s name:
Manager’ phone number:
Rent paid Monthly:
OCCUPANT 3 Previous address you lived at:
Street address:
City:
State:
Zipcode:
How long did you live here?
Manager’s name
Manager’ phone number
Rent paid Monthly:
OCCUPANT 3 Relatives / Emergency Contact (Not residing with you)
Last name:
First Name:
Street address:
City:
State:
Zipcode:
Email:
Cell Phone Number:
OCCUPANT 3:
Financial Background
Other sources of income:
Do you have credit problems?
Have you ever been evicted?
If yes, explain:
Do you have any pets?
If yes, What type and how many:
Applicant represents that all the above statements made are true and correct and hereby authorizes verification of the above information including but not limited to credit checks, criminal records, and agrees to furnish additional credit references and reports on request. Applicant authorizes verification of the information contained herein solely for the purpose of establishing qualifications as a tenant. Applicant releases anyone verifying such information or providing information, from liability. Applicant understands that incomplete or incorrect information provided in the application, may cause a delay in processing and can result in denial of tenancy.
DATE
