fax: 314-432-5240 Spencan Properties LLC
office: 314-609-9561 PO. Box 28341
email: $30 Application fee St. Louis, MO 63146
Rental Application
Name (Mr./Ms.)______________________________________________
Phone number (______)_________________
Social Security Number___________________________________
Date of Birth_______________________________
Driver’s License Number (if different from SSN)_________________________________
Marital StatusMarried Separated Widowed Divorced Single How long?______________________
Reason for Moving (check as many as apply):
Getting married Getting divorced or separated Nicer apartment Lower rent Living at home Roommate moved Job transfer Moving from another area Other (please state)________________________
Present address_________________________________________ ZIP code____________ How long?_____________
Landlord’s name___________________________________ Phone (_____)___________ Rent____________wkmo
Previous address How long?_________________________
Landlord’s name Phone (_____)___________ Rent_________wkmo
CHARACTER REFERENCES (other than spouse)
Name_______________________________________
Relation_____________________________________
Address_____________________________________
Phone______________________________________
Name_______________________________________
Relation_____________________________________
Address_____________________________________
Phone______________________________________
EMERGENCY CONTACT (different from above)
Name_______________________________________
Relation_____________________________________
Address_____________________________________
Phone______________________________________
BANK REFERENCES
Bank name___________________________________________
Checking Account Number______________________
Address______________________________________________
Savings Account Number______________________
Is your paycheck currently being garnished for any reason, including child support? YesNo Indicate amount_______
Year Make License Number Monthly Payment Balance
Bank & Acct.#
I, ___________________________________, agree to rent house/Apartment Number__________ at____________________
_____________________________for $______________per month/week and follow all house rules. I understand that any false statements made herein can subject me to full prosecution under the law. I hereby give Spencan Properties LLC, its owners and authorized agents, permission to check my credit and/or prior Residencies for purposes of approving or rejecting this rental application.
Signed:______________________________________________________ Date:_______________________________
LEAD WARNING STATEMENT
The house/apartment that I wish to rent was constructed prior to 1978 and therefore may contain lead-based paint. Lead from paint, paint chips, and dust can pose health hazards if not taken care of properly. Lead exposure is especially harmful to young children and pregnant women. If I am renting any apartment larger than a “zero-bedroom” apartment,
I HAVE READ AND I FULLY UNDERSTAND the above disclosure.
Signed:_______________________________________________________
Date:______________________________
Employed by___________________________________ Position_______________________ How long?___________
Address________________________________________
ZIP code__________ Phone(______)__________________
Supervisor_________________________________ Phone(_____)_____________ Salary____________hrwkmo
Previous employer______________________________ Position_______________________ How long?____________
Address________________________________________ ZIP code__________ Phone(_______)__________________
Supervisor_________________________________ Phone(_____)_____________ Salary____________hrwkmo
Other income: Source__________________________________________________
Amount _____________wkmo
THE FOLLOWING PEOPLE AND NO OTHERS ARE ALLOWED TO OCCUPY THE HOUSE/APARTMENT:
Name/Birth date__________________________________
Name/Birth date___________________________________
Children
(Names/Birth dates)________________________________________________________________________
(Names/Birth dates)________________________________________________________________________
(Names/Birth dates)________________________________________________________________________