Rental Application

Anita's Rentals *405 NW North St. Pullman, WA 99163 * (509) 332-8602
http://anitasrentals.com * anita@anitasrentals.com

Personal Information
Unit applying for: ____________________Name: ___________________________________

Current phone: _____________________ E-mail: ___________________________________
Parents/Emergency address _____________________________________________________
Parents/Emergency phone ______________________________________________________
Date of birth ____________ Major_________ ____________ Student ID ________________
Drivers license no _________Type of car _________________ License and state ___________
Pets? List all: _____________________________________________

Rental References
Current - Please give address, unit #, city, state and zip ________________________________

__________________________________________________________________________
Move-in date ____________ Move-out date ______________ Monthly rent ______________

Landlord name _____________________________________ Phone ___________________

Previous - Please give address, unit #, city state and zip ________________________________

__________________________________________________________________________
Landlord name _____________________________________ Phone ___________________
Move-in Date ______________ Move-out Date ______________ Monthly Rent ___________

[] I give Anita Hornback permission to access my Student Housing record/rental reference.

Employment (current or former employer)
Employer name, address _______________________________________________________
Employer phone _____________________________________________________________
Supervisor name _______________ Begin date _____ Salary ______Title _________________
If not employed, what source of income will you use to pay rent __________________________
__________________________________________________________________________

Character Reference - please provide other than a relative or peer, who can speak to your character
Please give name and phone ____________________________________________________
Have you ever been evicted from tenancy? _______
Have you ever willfully and intentionally refused to pay rent when due? _______
Do you know of anything which may interrupt your income or ability to pay
rent? ____________________________________________________

I hereby certify that the answers I have given in this application are true and correct to the best of my
knowledge. I understand that any false answers of statements made
by me will be sufficient grounds for eviction and loss of any
security deposit.
Date ______________________ Signature _____________________________________