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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: