Bluegrass Rental Properties, LLC Medical View Properties, LLC Bluegrass Commons, LLC P.O. Box 481 London, KY 40743-0481 RENTAL APPLICATION This Rental Application ( Application ) and the contents hereof will be used by Bluegrass Rental Properties, LLC or the above-named subsidiaries ( Landlord ) in considering whether to lease, and if a Lease is entered into by the Applicant and Landlord, the contents hereof will be incorporated into the terms of said Lease. This Application is NOT a lease agreement and does not bind or otherwise commit Landlord to leasing any real property to the Applicant. A separate Application is required for each applicant/potential tenant. AND RETURN AS AN ATTACHMENT TO E-MAIL*** ***PLEASE TYPE YOUR ANSWERS PROPERTY SOUGHT TO BE LEASED: APPLICANT: Full Name: Date of Birth: Social Security #: Driver s or ID #:_ State of issuance: Phone #:_ Phone #: E-mail: Current Address: Dates of Residency at current location: Current Monthly Rent: Name of Current Landlord: Phone # of Current Landlord:
Previous Address: Dates of Residency at previous location: Previous Monthly Rent: Name of Previous Landlord: Phone # of Previous Landlord: Current Employer: Employer s Address: Job Title: Length of Employment: Work phone: Monthly Earnings: Supervisor s name: Phone #: Previous Employer: Employer s Address: Job Title: Length of Employment: Work phone: Monthly Earnings: Supervisor s name: Phone #: (An additional application MUST be filled out be each additional applicant) 2
List all other persons who will be occupying the apartment/home, but not signing the lease: List all to be parked on the premises Make: Model: Year: License #: Make: Model: Year: License #: Will you or other occupants have a pet? If Yes, what kind: Has Applicant, Co-Applicant, or any other Occupant listed herein ever: Been convicted of a felony offense? Broken a rental agreement or lease contract? Been evicted or asked to move out? Declared bankruptcy? Been sued for non-payment of rent? Been sued for damages to a rental property? If any of the above answers are Yes, please explain: 3
Why are you leaving your present address? In case of an emergency, notify: Name: Relationship: Address: Phone #: _ Alt. Phone #: In the event of serious injury or death of the Applicant of Co-Applicant, the above-listed person may or may not enter the apartment/home and remove and/or store all contents found in the dwelling, adjoining areas, and mailbox. Personal References: Name: Relationship: Phone: Name: Relationship: Phone: The undersigned represents that all of the above statements are true and complete. Landlord is authorized to verify such information by consumer reports, rental history reports, criminal reports and other means, but is not required to make verifications or investigations. 4
Failure to answer the above inquiries of false information given above shall entitle Landlord to (1) reject this application, (2) retain the application fee(s) and deposit(s) as liquidated damages for the time and expenses of processing the application, and (3) terminate resident s right of occupancy. Landlord reserves the right to regularly and routinely furnish information to consumer reporting agencies about performance of lease obligations by the undersigned. Landlord also reserves the right to furnish any information to future inquiring landlords performing due diligence & screening the undersigned when considering the undersigned for tenancy of their property. Such information may be reported at any time & via any means (verbal or written communication) and may include both favorable and unfavorable information regarding the undersigned s compliance with the lease, rules, and financial obligations. The undersigned shall hold Landlord harmless for any information furnished to any consumer reporting agencies or future landlords. Applicant hereby expressly authorizes, permits, allows, consents, directs and agrees that all his/her prior landlords may be contacted, be communicated with and discuss Applicant s leasing other real property from such landlords with the Landlord herein, and such contact, communication and/or discussion may include, without limitation, timeliness of Applicant s prior payment of rent, whether Applicant defaulted under such prior lease, the length and terms of such prior lease, whether a forcible detainer action was filed and if so the results of same, and the circumstances of termination of such prior lease. Landlord has no duty to provide emergency care or give notice of an emergency to any person and shall not be liable to the undersigned, occupant, or any guest for failure to do so. The undersigned is responsible for any and all damages to their personal property resulting from any cause whatsoever. IT IS THE RESIDENTS SOLE RESPONSIBILITY TO CARRY RENTAL INSURANCE FOR ALL OF THEIR PERSONAL PROPERTY DO NOT SIGN UNTIL YOU HAVE READ AND FILLED OUT THIS DOCUMENT IN FULL. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. The undersigned Applicant hereby acknowledges that he/she has read, understands, and agrees to all the above paragraphs and is not relying on any verbal statements made by Landlord. Signature of Applicant Date Landlord contact information: Bluegrass Rental Properties, LLC Medical View Properties, LLC Bluegrass Commons, LLC P.O. Box 481 London, KY 40743-0481 859-494-8075; 859-252-5858 Bluegrassrentals@gmail.com 5