Applicant Name:
Current Address:
Cell: Home: Work:
Email:
Manager: Driscoll Property Management
Address: 146 N. Brown St. Rhinelander, WI 54501
Phone: (715)362-3040   Fax: (715)362-3043
UNIT INFORMATION         This is NOT a lease or rental agreement.
The Undersigned hereby makes application to rent apartment / Unit / number
located at .   Monthly Rent: $   Lease Term:
APPLICANT INFORMATION    Each Co-Applicant (named tenant) must complete a separate Rental Application.
Full Name:   Home Phone:
Date of Birth:   Driver's License:   Work Phone:
Emergency Contact:
Pets to Occupy Unit (Number and Kind):
Name of Other Persons (Non-Applicants) to Occupy Unit Identification Birth Date (under 18)
1.
2.
3.
4.
5.
APPLICANT RENTAL HISTORY    (Last 3 years)
Have you ever failed to pay rent when due? Yes    No
Have you ever been evicted? Yes    No
Current Address:   Rent: $
Since (date):   Landlord:   Phone:
Previous Address:   Rent: $
Since (date):   Landlord:   Phone:
APPLICANT EMPLOYER & INCOME
Present Employer:   Address:
Phone:   Since (date):   Monthly Pay:   Position:
Previous Employer:   Address:
Phone:   Since (date):   Monthly Pay:   Position:
OTHER SOURCES OF INCOME    You do NOT have to reveal alimony, child support or spouse's annual income unless you want it considered in this application.
Amount Source Confirmation Person Phone
1.
2.
3.
APPLICANT CREDIT REFERENCES
Have you ever filed for bankruptcy? Yes    No
Bank City/State Details
1.
2.

Credit Reference Address and/or Phone
1.
2.
Comments:
The purpose of this application is to determine whether I quality as a tenant. If my application is approved, the Landlord and I shall sign a written lease or rental agreement. The Landlord and I have no rental agreement until the time that the lease or written rental agreement is signed.

I have paid the earnest money deposit and credit report fee indicated on this application. The earnest money deposit will be applied to my security deposit or my first month's rent if the Landlord enters into a lease or rental agreement with me. If this application is approved, and I fail to enter into a lease or rental agreement, the earnest money and any subsequent payments may be retained to compensate the Landlord's costs and damages, subject to the Landlord's duty to mitigate. The earnest money and any subsequent payments will be refunded to me by the end of the next business day if: 1.) this application is rejected, or withdrawn before approval; or 2.) if the Landlord takes no action on this application by the end of the 21st day following the Landlord's receipt of the earnest money. The credit report fee is non-refundable.

I hereby authorize the Landlord and Manager to investigate my credit and financial responsibility, income, rental and eviction history, and the statements made in this application, and to obtain a consumer credit report on me from a consumer reporting agency that compiles and maintains files on consumers on a nationwide basis. My performance under any lease or rental agreement that I may enter into with the Landlord may be reported to such reporting agency.

I acknowledge that the Manager and the agents and employees thereof represent the interests of the Landlord, but they also have a duty to treat all parties fairly and in accordance with the fair housing law, and to disclose material adverse facts about the property.

I was given the opportunity to review a sample lease or rental agreement, and the Landlord's rules and regulations. I warrant and represent that I am at least 18 years of age and that all statements herein are true and correct, to the best of my knowledge.

Notice: You may obtain information about the sex offender registry and persons registered with the registry by contacting the Wisconsin Department of Corrections on the Internet at http://www.widocoffenders.org or by phone at 877-234-0085.

Signature of Applicant:
By selecting "Yes" you are verifying that you are indeed the applicant listed in the fields above and 18 years of age or older.
Yes    Date: 12/13/2017