Ned Baker Real Estate, Inc. - Online Rental Application

2339 State St • Salem, OR 97301 • 503.364.6797 • 877.893.6797 • 503.364.6798 fax

Property Address:

Rent $

Applicant #1

Applicant #2

Legal name:		Legal name:
Social Security #		Social Security #
Date of Birth:		Date of Birth:
Drivers Lic#		Drivers Lic#
State:		State:
Vehicle Make/Yr		Vehicle Make/Yr
Lic.#		Lic.#

Residence History - Applicant #1

Residence History - Applicant #2

Present Address:		Present Address:
Home Phone:		Home Phone:
Work Phone:		Work Phone:
Email address: valid email required		Email address:
Rent or own:		Rent or own:
Date of move-in		Date of move-in
Landlord Name		Landlord Name
Landlord Phone		Landlord Phone

Previous. Residence History - Applicant #1

Previous Residence History - Applicant #2

Previous Address:		Previous Address:
Rent or own:		Rent or own:
Date of move-in		Date of move-in
Date of move-out		Date of move-out
Landlord Name		Landlord Name
Landlord Phone		Landlord Phone

Income Description - Applicant #1

Income Description - Applicant #2

Employer name:		Employer name:
Complete address:		Complete address:
Telephone #		Telephone #
Gross:		Gross:
Net:		Net:
How often?		How often?
Date of Hire:		Date of Hire:
Additional Sources of Income (List Source and how frequently)		Additional Sources of Income (List Source and how frequently)
Source 1		Source 1
Source 2		Source 2
Total monthly income		Total monthly income

Other Important Information For Both Applicants

List names, and date of birth, for all persons to occupy the unit		An aquarium?
		Have you been evicted?
Do you have pets?		Have you been convicted of a felony?
Type:		Do you have current renters insurance?
Do you use a waterbed?

Applicant(s) hereby certify that the information is true and correct and hereby authorize NedBakerRealEstate to make any necessary inquiries deemed necessary to evaluated the application for tenancy and credit standing. APPLICANT UNDERSTANDS AND ACCEPT THAT ANY INFORMATION PROVIDED THAT IS INCOMPLETE, INACCURATE, OR FALSIFIED SHALL BE GROUNDS FOR DENIAL OF THE APPLICATION OR SUBSEQUENT TERMINATION OF TENANCY UPON.

Initials below verifies acceptance of terms.

Applicant1 initials
Applicant2 initials

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