Rental Application - Diversified Property Management
Equal Housing Opportunity
WHERE DID YOU FIND US?
1: [ ] Flyer: Where?_____________ [ ] ForRent.com [ ] Rent.com
[ ] Newspaper: ______________ [ ] Apartments.com [ ] 411 Magazine [ ] Other______________
2: Property Address: _____________________.3: Anticipated move date of ___________at a monthly r
ent of $_________ plus cable [ Y ] [ N ] plus security deposit of $_________ plus last month’s rent
$_________. Total move-in cost $__________.
PLEASE TELL US ABOUT YOURSELF
Full Name__________________________________________________ Home Phone ( )
________________________
Date of Birth_________________________________ Social Security
#__________________________________________
Email Address:__________________________________________(optional) Other Phone ( )
___________________
Co-Applicant Name_________________________________________ Names of
Dependents_________________________
Co-Applicant Date of Birth______________________ Social Security
#__________________________________________
Dependents Date of
Birth________________________________________________________________________________
List All
Pets__________________________________________________________________________________
________
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address: _______________________________Apt#________ City__________________
State______ Zip________
Month/Year Moved In______________________ Reasons for Leaving
____________________________Rent $__________
Owner/Agent__________________________________________________Phone ( )
____________________________
Previous Address (last 3 years)_________________________________________________________Rent
$____________
Owner/Agent__________________________________________________Phone ( )
____________________________
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you ever committed a misdemeanor or felony offense?
If yes, what offense?___________________________________________ Yes___________
No____________
Have you ever been evicted from a rental residence? Yes___________ No____________
Have you had two or more late rental payments in the past year? Yes___________ No____________
Have you ever willfully or intentionally refused to pay rent when due? Yes___________
No____________
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: _____Full Time _____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________
________________
Dates employed_______________________________ Employed
as______________________________________________
Supervisor Name______________________________________________ Phone ( )
______________________________
Salary $_________________per________________. TOTAL MONTHLY INCOME: $______________
If employed by above less than 12 months, give name & phone of previous employer or school:
___________________________
If you have other sources of income that you would like us to consider, please list income, source, and
person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony,
child support, or spouse's annual income unless you want us to consider it in this application.
Amount $___________________ Source/Contact
Name__________________________________________________________
PLEASE LIST YOUR REFERENCES
Banking Accounts:
Name_________________ Type of Account_________________ Account Number_________________
Name_________________ Type of Account_________________ Account Number_________________
Personal Reference or Emergency Contact:
Name _____________________ Address ____________________________Phone ______________
Relationship__________
Name _____________________ Address ____________________________Phone ______________
Relationship__________
Driver's License:
Your Driver's License Number_________________ State_________________
Vehicle Information:
Make / Model _________________Year _________________License Plate State_________________
Authorization Release of Information: I Authorize Diversified Property Managment whose address is 3320
Longfellow Ave. S.Suit#107, Mpls, Mn. 55407 and Multi housing Credit Control Whose address is 10125
Crosstown Circle, Suit #100, Eden Prairie, MN 55344 to investigate criminal history, residential,Employment,
and income history, bank and credit history for the purpose of housing and/or employment. The source of
information may come from, but is ;not limited to credit bureaus banks and other depository institutions
current and former employers federal or state records including employment security agencies records count
or state records as fallows, or other course Require fit is understood that a photocopy or facsimile copy of
this form will serve as authorization.I understand failure to complete this form completely and truthfully may
result in denial and/or forfeiture of Deposit this authorization is for this transaction only and continues in
effect for one (1) year unless by state law,in which case the authorization continues in effect for the maximum
Period not to exceed one (1) year,allowed by law.
_____________________________________________
Name's (please print)
X_______________________________________ __________________________
Signature Date
X_______________________________________ __________________________
Signature Date
Equal Housing Opportunity
WHERE DID YOU FIND US?
1: [ ] Flyer: Where?_____________ [ ] ForRent.com [ ] Rent.com
[ ] Newspaper: ______________ [ ] Apartments.com [ ] 411 Magazine [ ] Other______________
2: Property Address: _____________________.3: Anticipated move date of ___________at a monthly r
ent of $_________ plus cable [ Y ] [ N ] plus security deposit of $_________ plus last month’s rent
$_________. Total move-in cost $__________.
PLEASE TELL US ABOUT YOURSELF
Full Name__________________________________________________ Home Phone ( )
________________________
Date of Birth_________________________________ Social Security
#__________________________________________
Email Address:__________________________________________(optional) Other Phone ( )
___________________
Co-Applicant Name_________________________________________ Names of
Dependents_________________________
Co-Applicant Date of Birth______________________ Social Security
#__________________________________________
Dependents Date of
Birth________________________________________________________________________________
List All
Pets__________________________________________________________________________________
________
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address: _______________________________Apt#________ City__________________
State______ Zip________
Month/Year Moved In______________________ Reasons for Leaving
____________________________Rent $__________
Owner/Agent__________________________________________________Phone ( )
____________________________
Previous Address (last 3 years)_________________________________________________________Rent
$____________
Owner/Agent__________________________________________________Phone ( )
____________________________
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you ever committed a misdemeanor or felony offense?
If yes, what offense?___________________________________________ Yes___________
No____________
Have you ever been evicted from a rental residence? Yes___________ No____________
Have you had two or more late rental payments in the past year? Yes___________ No____________
Have you ever willfully or intentionally refused to pay rent when due? Yes___________
No____________
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: _____Full Time _____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________
________________
Dates employed_______________________________ Employed
as______________________________________________
Supervisor Name______________________________________________ Phone ( )
______________________________
Salary $_________________per________________. TOTAL MONTHLY INCOME: $______________
If employed by above less than 12 months, give name & phone of previous employer or school:
___________________________
If you have other sources of income that you would like us to consider, please list income, source, and
person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony,
child support, or spouse's annual income unless you want us to consider it in this application.
Amount $___________________ Source/Contact
Name__________________________________________________________
PLEASE LIST YOUR REFERENCES
Banking Accounts:
Name_________________ Type of Account_________________ Account Number_________________
Name_________________ Type of Account_________________ Account Number_________________
Personal Reference or Emergency Contact:
Name _____________________ Address ____________________________Phone ______________
Relationship__________
Name _____________________ Address ____________________________Phone ______________
Relationship__________
Driver's License:
Your Driver's License Number_________________ State_________________
Vehicle Information:
Make / Model _________________Year _________________License Plate State_________________
Authorization Release of Information: I Authorize Diversified Property Managment whose address is 3320
Longfellow Ave. S.Suit#107, Mpls, Mn. 55407 and Multi housing Credit Control Whose address is 10125
Crosstown Circle, Suit #100, Eden Prairie, MN 55344 to investigate criminal history, residential,Employment,
and income history, bank and credit history for the purpose of housing and/or employment. The source of
information may come from, but is ;not limited to credit bureaus banks and other depository institutions
current and former employers federal or state records including employment security agencies records count
or state records as fallows, or other course Require fit is understood that a photocopy or facsimile copy of
this form will serve as authorization.I understand failure to complete this form completely and truthfully may
result in denial and/or forfeiture of Deposit this authorization is for this transaction only and continues in
effect for one (1) year unless by state law,in which case the authorization continues in effect for the maximum
Period not to exceed one (1) year,allowed by law.
_____________________________________________
Name's (please print)
X_______________________________________ __________________________
Signature Date
X_______________________________________ __________________________
Signature Date
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