Paradise Property Management
P.O. Box 123
Anytown, UT 12345

(435)740-1111

Lease/Rental Application

Personal Information:
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Date of Birth
Social Security Number
Is there someone you would like to room with?

Employment Information
Employer:
Superviser phone:
How long employed:

Permanent Home Information
Name of Parent or Guardian
Home Address
Home Phone
 

Previous Rental Information
Landlord:
Landlord's phone:
How long at previous address:
 

Terms and Conditions
The following conditions are to be met without any exceptions.
Requirements:
I understand that there is no smoking allowed on the premises
I understand that no pets are allowed
I understand that there is to be no alcohol on the premises
 

I CERTIFY that answers given herein are true and complete to the best of my knowledge. I AUTHORIZE verification of the information contained in this application for tenant screening as may be necessary in arriving at a tenant decision including the obtaining of a credit report. I understand that the landlord may terminate any rental agreement entered into for any misrepresentations made above.  I consent to allow the Owner/Agent to disclose tenancy information to previous or subsequent Owners/Agents.
Electronic signature:
Confirm signature:
I agree
Desired move-in date:
 

 If your application is not approved, your deposit will be returned.  If your application is approved, it will be held and refunded contingent upon the terms of the agreement and the condition of the property at the end of your lease/rental term. If you leave before the end of the contract, your entire deposit will be forfeited and you will be required to pay the remainder of the contract unless other arrangements have been made with the landlord.   (Your bank statement may show "Instant Payments" or "Rental Fees" on processed payments.)

Acceptance of the application will be contingent on receiving all completed paperwork,
the deposit and a positive response from your previous landlord.
 
Deposit:   $200.00   Item Subtotal:  
$200.00
Total:
$200.00
Payment Information
Method of Payment:
Update name from Personal Information
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Personal Information
Cardholder's Name:
Billing Street:
Billing ZIP/Postal Code:
Use Instant Payments to accept payments for your business.
SIP Program & Data © 2006-2019 Instant Payments All rights reserved.
~ Terms & Conditions ~ Privacy Policy ~ Contact Us ~
SIP Version 2.19; API: 2.6
RSI Security Instant Payments, Payment Processing Service, Clinton, UT Get Help