Rental Credit Application

Note: The online submit feature is temporarily disabled due to changes being made at the host server. You may download or print this application and email it as an attachment, or use it as a guide and call or email our office. Contact info: Phone 417-881-8100 or email us!

Your email address:
The address of the property you are interested in:

Applicant 1--
Name:
Social Security Number:
Phone: Cell Phone:
Current Residence:
Street Address:
City: State: Zip:
How Long? Landlord's Phone:

Prior Residence:
Street Address:
City: State: Zip:
How Long? Landlord's Phone:

Employment--
Current employment:
How long? Salary?: Phone:
Prior employment:
How long? Salary?: Phone:
List source and amount of other income:

Applicant 2--
Name:
Social Security Number:
Phone: Cell Phone:
Current Residence:
Street Address:
City: State: Zip:
How Long? Landlord's Phone:

Prior Residence:
Street Address:
City: State: Zip:
How Long? Landlord's Phone:

Employment--
Current employment:
How long? Salary?: Phone:
Prior employment:
How long? Salary?: Phone:
List source and amount of other income:
Applicant 3--
Name:
Social Security Number:
Phone: Cell Phone:
Current Residence:
Street Address:
City: State: Zip:
How Long? Landlord's Phone:

Prior Residence:
Street Address:
City: State: Zip:
How Long? Landlord's Phone:

Employment--
Current employment:
How long? Salary?: Phone:
Prior employment:
How long? Salary?: Phone:
List source and amount of other income:
Bank--
Name: Phone:
Checking Account Number:
Savings account Number:
Years at this bank:
Vehicles--
Number of vehicles (inluding company cars):
Vehicle 1 Make and Model:
Color: License Plate No: State:
Vehicle 2 Make and Model:
Color: License Plate No: State:
Vehicle 3 Make and Model:
Color: License Plate No: State:
Rental History--
Have you ever filed for bankruptcy? If "yes", when?
Have you ever been served an eviction notice or asked to vacate a property? If "yes", when?
Have you ever willfully or intentionally refused to pay rent when due?
Personal References--
Name:
Relationship: How Long:

Name:
Relationship: How Long:

Name:
Relationship: How Long:

By clicking submit, the above stated applicants acknowledge and affirm the following:
I understand I acquire no right in the property until I sign an agreement in the form submitted to me and make the required deposit. In consideration of the Landlord’s holding the property for me, I hereby waive all right to the return of this deposit and said deposit shall be retained as liquidated damages in the event I do not choose to enter into the agreement applied for herein. In the event said application for tenancy is not accepted, deposit shall be returned to applicant. Notice to Prospective Tenant: Radon is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient quantities, may present health risks to persons who are exposed to it over time. Levels of radon that exceed federal and state guidelines have been found in buildings in this state. Additional information regarding radon and radon testing may be obtained from your county public health unit. Every purchaser of any interest in residential real property on which a residential dwelling was build prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient, behavioral problems and impaired memory. Lead poisoning also poses a particular risk to pregnant women. The seller of any interest in residential real estate is required to provide the buyer of any known lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase. I/we declare the foregoing information is true and correct, and I/we hereby authorize you to conduct an employment and credit check and to verify our references.