HOFFMAN REALTY Phone: 402-341-3709 Fax: 402-505-8349

RENTAL APPLICATION

Please provide the current information below:

Full Name
Date of Birth
Social Security Number	Drivers License Number: State:

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
Work Phone
Cell Phone
E-mail

Please provide previous address:

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code
Current Landlord Information:

Landlord Name

Realty Company

Phone

Rent $

Reason Moving
Employment Information:

Current Employer

Occupation

How long there

Supervisor

Phone
Additional Employment Information (complete if you have a second job)

Employer

Occupation

How long there

Supervisor

Phone
Interested in which Hoffman Realty Property:
Looking for how many bedrooms:
Net income per month current job:
Net Income per month 2nd job (if applicable):
Car Payment:
Desired Rental Start Date:
-- mm/dd/yy
Ever denied rental?

Yes No
Ever evicted:

Yes No
Rent ever late:

Yes No
Past credit problems:

Yes No
If so, please explain past credit problems:
If student, please include parent information: name, address and telephone number:

I hereby state that the information given in this application is complete and accurate. A $25 non refundable application fee is (is not) enclosed and will be credited to the security deposit when and if applicant signs a lease.

NO WATERBEDS OR DOGS ARE ALLOWED.

I have inspected the premises and they are acceptable. The undersigned hereby acknowledges and agrees that Hoffman Realty may contact persons or businesses listed on this application and authorizes them to release all pertinent information.

I hereby authorize and instruct the Landlord or Landlord’s agents to verify the information contained in my rental application. Verification or re-verification of any information contained in the application will be retained by Landlord. I hereby authorize and instruct Tenant Data Services Inc. and/or the Landlord/Landlord’s agents to obtain information about me, including, but not limited to, information relating to this application, my credit reports, my tenant history, my check writing history, any court records and/or my criminal record and I hereby authorize & instruct any entity or person contacted by Tenant Data Services Inc. or the Landlord or Landlord’s agents, including all credit reporting agencies, to release such information to them. Upon request, Tenant Data will provide the name & phone number of the source of the information used in the verification and/or information gathering process.

By entering your name in this block and clicking submit you agree to the above terms.

Current Employer
Occupation
How long there
Supervisor
Phone

Realty Company
Phone
Rent $
Reason Moving