Form Log-In Account (Optional)

New/Returning Users: Please CLICK HERE to setup or return to your account for this Application. By creating an account, you will be able to partially complete this Application, save it, and return to your account later to view or finish your Application. If you feel you can fully complete this Application at this time, you are welcome to fill the form below and submit your Application without creating an account.

Personal Information (Section 1 of 5)

* Indicates Response Required

Community of Interest

Number of Bedrooms

Target Move In Date (Estimate) +

Are you a co-signer? *

Yes

No

Who are you co-signing for? *

Name (First, M , Last) *

Date Of Birth (1/11/79) *

Age

Social Security Number *

Spouse (First, M, Last)

Date Of Birth (1/11/79)

Age

Social Security Number

Present Address (Street) *

State, City, Zip *

Do you own or rent this home? *

Own	Rent
Parent (Rent)	Parent (Own)

Best Daytime Phone *

Work Phone

E-Mail *

Spouse Email

Present Landlord/Mortgage Company *

Phone Number *

Monthly Payment

Length Of Residence (Yrs./Mths.)

Reason For Moving From Present Address

Previous Address (Street, City, State, Zip)

Length Of Residence (Yrs./Mths.)

If you have previously rented from Langley, please provide the address and termination date of the lease

If someone else will occupy the premises, what is his/her name?

Age

Relationship To You

If someone else will occupy the premises, what is his/her name?

Age

Relationship To You

Employment Information (Section 2 of 5)

Present Employer *

Years Employed *

Months Employed *

Position *

Contact Person *

Employer's Address (Street, Cty, State, Zip)

Phone Number *

Salary Amount

Salary Type

Previous Employer *

Years Employed *

Months Employed *

Position *

Address & Phone *

Spouse's Employer

Years Employed

Months Employed

Position

Contact Person

Spouse's Employer Address (Street, City, State, Zip)

Phone Number

Salary Amount

Salary Time

Spouse's Previous Employer

Years Employed

Months Employed

Position

Address & Phone

References (Section 3 of 5)

Personal Reference (Not related to you, preferably local)

Address

Phone Number

Financial References (Banks, Stores, Credit Unions, Finance Companies, Credit Cards, Etc.)

Financial Reference

Monthly Payment

Financial Reference

Monthly Payment

Financial Reference

Monthly Payment

Financial Reference

Monthly Payment

Additional Information (Section 4 of 5)

Do you own a vehicle? *

Yes

No

Automobile Make *

Model *

Year *

Financed By * 🛈

Payment * 🛈

Automobile Make

Model

Year

Financed By

Payment

Nearest Relative (Not living with you) *

Address *

Phone Number *

Relationship *

Select all of the following that you own

Have pets? *

Yes

No

How many pets & what type? If dog, list weight. *

If yes to dog, has it ever bitten someone? *

Yes

No

N/A

If yes to bitten someone, please state when. *

Are you in the process of, or considering bankrupcy? *

Yes

No

Will you have a waterbed? *

Yes

No

Have you been evicted from tenancy in the last 12 months? *

Yes

No

Have you ever been convicted or pleaded guilty or “no contest” to a misdemeanor or felony involving sexual misconduct, whether or not resulting in a conviction? *

Yes

No

Have you or anyone who will occupy a Langley Rental's property with you ever been listed on a registry of sexual offenders? *

Yes

No

Authorization (Section 5 of 5)

Please read the following and fill out the authorization below to complete your application.

False information given on the application will be cause for denial of this application or termination of the lease. As part of the processing procedure, an investigative report may be made whereby information is obtained through personal interviews with third parties. This inquiry is to obtain information on your character, general reputation and personal characteristics, whichever may be applicable. This information may be used for the purpose of rental verification and collections during or after occupancy.

This is to certify that I/We are above the legal age, that the information provided in this application is true and correct to the best of my/our knowledge, and that the information has been provided in order to induce consideration of this application.

*

I/We hereby authorize owner or agent of Langley Rentals to verify any and all information and obtain such character information, financial information, sexual offender information, and records as may be necessary for approval or rejection of this application.

If you are declined or offered an apartment with more stringent conditions based in part or in whole or your credit, you have a right to obtain a free copy of your credit report from the Credit Bureau if you request it within 60 days. You have the right to dispute directly with the credit bureau the accuracy or completeness of the information on your credit report. You will receive a letter with contact information for the Credit Bureau.

By filling out the sections below and submitting this application, I authorize that I have read and understand the aforementioned.

Initials *

Name (First, M., Last) *

Social Security (Last 4 digits) *

Initials

Name (First, M. Last)

Social Security (Last 4 Digits)

Camper	Motorcycle	Boat
Truck	Trailer	Not Applicable