Rental Application
Paige Properties Of Mountain Home
21 North Star Circle, Mtn. Home, AR 72653
Phone & Fax: (870) 424-7888
How Did You Hear About Us?
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What Are Are Looking To Rent?
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How soon are you looking to move?
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Are you interested in our Utilities Included Package for another $200/month?
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Applicant #1 Information -
All questions in this section apply to Applicant #1. Please note that it does not matter who is Applicant #1 or #2
Name
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Phone
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Social Security Number
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Social Security Number
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Date Of Birth
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Email
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Marital Status
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Present Address
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How Long Have You Lived There?
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Why Are You Leaving?
Landlord's Name:
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Landlord's Phone
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Employer
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Employment Address
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Occupation
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How Long Have You Worked There?
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How Much Is Your Monthly Income?
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Your Bank's Name
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Your Bank's City
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Checking Account Number
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Savings Account Number
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Applicant #2 Information -
All questions in this section apply to Applicant #2. Please note that it does not matter who is Applicant #1 or #2
Name
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Phone
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Social Security Number
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Social Security Number
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Date Of Birth
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Email
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Marital Status
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Present Address
How Long Have You Lived There?
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Why Are You Leaving?
Landlord's Name:
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Landlord's Phone
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Employer
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Employment Address
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Occupation
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How Long Have You Worked There?
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How Much Is Your Monthly Income?
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Your Bank's Name
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Your Bank's City
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Checking Account Number
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Savings Account Number
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All Occupant Information
Include yourself, children, relatives and any other co-residents (spouses, significant others, roommates) when filling out this section.
Name, Age, Relationship
List the name, age, and relationship of ALL PERSONS to be occupying the premises
Name
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Date Of Birth
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Relationship
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Name
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Date Of Birth
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Relationship
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Name
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Date Of Birth
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Relationship
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Name
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Date Of Birth
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Relationship
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Name
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Date Of Birth
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Relationship
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Name
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Date Of Birth
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Relationship
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Name
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Date Of Birth
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Relationship
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Vehicles
List All The Vehicles To Be Parked On The Premises By Applicant, Co-Applicant, Or Children Including Cars, Trucks, Motorcycles, Trailers, Boats, Etc.
Vehicle Type
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Year
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License Number
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State
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Color
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Vehicle Type
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Year
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License Number
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State
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Color
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Vehicle Type
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Year
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License Number
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State
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Color
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Vehicle Type
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Year
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License Number
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State
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Color
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Applicant #1 Driver's License Number
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Applicant #2 Driver's License Number
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What Type Of Pet Is It?
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How Old Is Your Pet?
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Background History
If Yes, Who And Why?
If Yes, Who And Why?
If Yes, Who And Why?
If Yes, Who And Why?
Who Was Convicted?
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What Was The Felony For?
When Was The Conviction?
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Emergency Information
Nearest Living Relative
Name 1
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Relationship To Applicant Or Co-Applicant
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Address 1
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Phone 1
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Name 2
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Relationship To Applicant Or Co-Applicant
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Address 2
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Phone 1
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List Nearest Friend
Name
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Phone
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Address
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In Case Of Emergency Please Contact:
This Contact Should Be Someone Other Than 911
Name
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Relationship To Applicant or Co-Applicant
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Address
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Phone
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I declare that the foregoing information is true and correct, I authorize Paige Properties management permission to obtain it's verification by phone, mail, internet, or consumer credit report now, and at any time in the future for whatever reason deemed necessary by Paige Properties or the agents thereof. I understand that falsified information on this application is grounds for rejection and/or eviction if a lease is in effect.
Applicant #1 Signature
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Applicant #2 Signature
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Date Of Signing
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There Will Be A $25.00 Service Fee PER APPLICANT On All Applicants Taken
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