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>> Main | Tenant Services | Online Lease Application

This form is for your convenience. The online application is a shortened version of the final application. If you are approved for occupancy, you may be required to complete the full application. If you are uncomfortable sending this information online, simply contact us and we can either fax or mail you an application, or click here to download a printable application. After you've printed and filled it out fax or mail it to us.



Applicant Information

First Name

Middle Name

Last Name

Social Security Number

Date of Birth

Driver License Number

Driver License State

Driver License Expiration Date

Home Phone

Work Phone

Ext

Mobile Phone

Fax Number

Email Address

Spouse Information

Spouse First Name

Spouse Middle Name

Spouse Last Name

Social Security Number

Date of Birth

Driver License Number

Driver License State

Driver License Expiration Date

Home Phone

Work Phone

Ext

Mobile Phone

Fax Number

Email Address

Current Address Information

Current Address

Apt/Unit Number

City

State

Zip

Own or Rent

Manager/Landlord Name

Manager/Landlord Phone

Ext

Move In Date

Move Out Date

Current Monthly Rent

Reason for Move

Previous Address Information

Previous Address

Apt/Unit Number

City

State

Zip

Manager/Landlord Name

Manager/Landlord Phone

Ext

Move In Date

Move Out Date

Monthly Rent

Reason for Move

Pet Information

Pets

If yes, describe pets (male, female, breed, spayed/neutered, age)

Employment Information

Self Employed

Employer

Address

City

State

Zip

Date Hired

Position

Supervisor's Name

Employer Phone

Ext

Monthly Income before taxes

Spouse Employment Information

Spouse Self Employed

Employer

Address

City

State

Zip

Date Hired

Position

Supervisor's Name

Employer's Phone

Ext

Monthly Income before taxes

Other Income Information

Other Source of Income

Monthly Amount

Person to Verify Amount

Phone

Ext

Total Monthly Income From All Sources

Other Occupants

Please list all proposed occupants in addition to yourself and your spouse.

Name

Age

Name 2

Age

Name 3

Age

Name 4

Age

Name 5

Age

Name 6

Age

Please answer the following questions:

Have you or any occupant ever broken a lease?

If yes, date

If yes, details

Have you or any occupant ever convicted of a felony?

If yes, date

If yes, details

Have you or any occupant ever removed from a rental by forcible action or any other legal action?

If yes, date

If yes, details

Please enter the information of the property you wish to lease:

Address

City

Date you wish to occupy home

Agreement

By submitting this application, you are accepting the following terms. You are declaring that all of the information on this application is true and correct. You give the landlord the authority to verify all information and request a report from a credit reporting agency. Houses may be held for future occupancy with a deposit.

 


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Judy Muselman Properties. All rights reserved.  

JUDY MUSELMAN PROPERTIES
276 S Lake Havasu Avenue A-11
LAKE HAVASU CITY, AZ 86403
Tel: 800-851-8082