Yamber Rental Application

Rental Address Desired

Personal Information

*Last Name *First Name Middle Name Date of Birth Phone Alternate Phone *Email Any other names used in the past

Has applicant ever broken a Lease? Yes No

Ever refused to pay for any reason? Yes No

Ever been evicted or asked to leave? Yes No

Ever filed bankruptcy? Yes No

Ever been convicted of a crime? Yes No

Do you give permission to do a criminal background check? Yes No

Is there anything to prevent you from placing utilities in your name? Yes No

Employment and Income Verification

Name of Current Employer Phone Number of Current Employer

Additional Occupants

Occupant 1

Name Date of Birth Relationship

Occupant 2

Name Date of Birth Relationship

Occupant 3

Name Date of Birth Relationship

Pets

Do you have any pets? What breed? How much does your pet weigh?

Residency History

Present Address Dates lived at this Address Monthly Rent Name of Present Landlord Landlords Phone # Address of Landlord Reason for Moving Is your rent current? Yes No

Number of late payments at this address

Security deposit currently held by landlord Have you had any reoccuring problems with your current home or landlord? Previous Address Dates lived at this Address Monthly Rent Name of Previous Landlord Landlords Phone #

I represent to you that I have read this entire application and that all of the information herein is true, correct and complete. If any of the above information is false, I hereby agree that my entire deposit may be forfeited to lessor and at lessor's option, may result in eviction. I understand that this application is subject to approval. My permission is given to run a credit check, a criminal background check and rental history check. My permission is also given for employment verification.

This office follows fair housing laws.

There is an application fee of $32 per person that may be paid by personal check or drop-off at our office.

If human, do not fill

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327 South 1st Street
DeKalb, IL 60115