Download LAST NAME - Pedinco LLC

APPLICATION TO RENT
PEDINCO LLC
Each individual occupant who is responsible for Rent
Payment MUST complete a separate application form
www.pedinco.com
Phone: (414) 306-1453
7411 N Santa Monica Blvd
Fox Point, WI. 53217
LAST NAME
FIRST NAME
MIDDLE NAME
SOCIAL SECURITY NUMBER
DATE OF BIRTH
DRIVERS LICENSE NUMBER
STATE
PHONE NUMBER
EMAIL ADDRESS
YES
1.
PRESENT HOME ADDRESS
LENGTH OF STAY
2.
WILL YOU HAVE ANY PETS?
NO
CITY
REASON FOR LEAVING
CITY
REASON FOR LEAVING
ZIP CODE
TELEPHONE #
STATE
ZIP CODE
LANDLORD NAME
CURRENT EMPLOYER
TELEPHONE #
POSITION
HOURLY/SALARY
EMPLOYER’S ADDRESS
CITY
NAME OF SUPERVISOR
TELEPHONE NUMBER
NAME OF YOUR BANK
ACCOUNT TYPE:
STATE
LANDLORD NAME
PREVIOUS HOME ADDRESS
LENGTH OF STAY
LIQUID FILLED FURNITURE
WILL NOT BE ALLOWED
HOW LONG
BRANCH ADDRESS
CHECKING
SAVINGS
ANNUAL INCOME
TELEPHONE #
ACCOUNT NUMBER:
ACCOUNT NUMBER:
IN AN EMERGENCY NOTIFY: NAME
ADDRESS
TELEPHONE #
REFERENCE 1. : NAME
ADDRESS
TELEPHONE #
REFERENCE 2. : NAME
ADDRESS
TELEPHONE #
AUTOMOBILE: MAKE:
MODEL
HAVE YOU EVER BEEN EVICTE OR ASKED TO MOVE?:
HAVE YOU EVER FILED FOR BANKRUPTCY?:
YEAR
YES:
YES
LICENCE #
NO
NO
Applicant represents that all of the above statements are true and correct and hereby authorize Pedinco LLC or agent to
verify the above items including, but not limited to, the obtaining of a credit report and agrees to furnish additional
credit references upon request. Pedinco LLC received a payment of $0 which will be used to verify Applicant’s credit
history and other background information.
The undersigned makes application to rent housing accommodation, designated as :
3356 N Bartlett Ave, Milwaukee, WI. 53211
Being the lower floor of a two family duplex, the rental for which is $1175.00 (One Thousand
One Hundred and Seventy five Dollars) per month and upon approval of this application
agrees to sign a lease and to pay all sums due, including deposits, before occupancy
Date:
Signature of Applicant: