UIP Property Management, Inc

Rental Application
	Please complete the form below.



(*) Required Fields
General Information
	First Name	*
	Last Name	*
	SSN	*
	Birth Date	*
	Email	*
	Phone Number	*
	Drivers License # / State	*
	Total # of Occupants	*
	Property/Address Applying For	*
	Desired Move-In Date	*	Enter desired move in date
	How did you hear about us?
	Requested Lease Term
	Other Information
Residence/Rental History
	Address	*
	City	*
	State-Province	*
	Zip Code	*
	Landlord/Manager Name
	Monthly Rent
	Dates of Residency (From/To)
	Reason for Leaving
	Landlord/Manager Phone
Employment/Income History
	Employer Name	*
	City	*
	Employer Phone
	Dates of Employment (From/To)
	Monthly Gross Pay	$*
	Occupation	*
	Additional Income (2nd job, etc)
	Assets (trust fund, car, etc)
References
	Name 1	*
	Phone 1	*
	Name 2
	Phone 2
Co-signer/Guarantor
	Co-signer/Guarantor Name
	Email
	Phone
Emergency Contact
	Emergency Contact Name
	Email
	Phone
Other Comments
	Comments
Application Agreement
I understand that this is a routine application to establish credit, character, employment, and rental history. I also understand that this is NOT an agreement to rent and that all applications must be approved. I authorize verification of references given. I declare that the statements above are true and correct, and I agree that the landlord may terminate my agreement entered into in reliance on any misstatement made above.
		I agree	Required
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