Rental Application

If you are a human and are seeing this field, please leave it blank.

Fields marked with a * are required

Rental Preferences

Date of Application

Desired Date of Occupancy

Desired Property

Personal Information

First Name *

Last Name *

Email *

Date of Birth *

Drivers License Number *

Phone *

Permanent Address

Address 1

Address 2

City

Zip / Post Code

Home Phone

Other Phone

Emergency Contact Information

Emergency Contact Name

Address

City

Zip / Post Code

Residence History

Current Address

City

Zip / Post Code

Date From:

Date To:

Monthly Payment

Previous Address

City

Zip / Post Code

Date From:

Date To:

Monthly Payment

Employment History

Present Employer

Date From:

Date To:

Position

Supervisor

Previous Employer

Date From:

Date To:

Position

Supervisor

Other Information

If yes, please explain

A co-signer is required if you are a student and do not have: adequate credit, two years of previous landlord references, and a full time job.

Co-signer Information

First Name

Last Name

Date of Birth *

Drivers License Number *

Home Phone

Other Phone

The landlord agrees to lease this property with compliance of all state and federal housing laws.

I certify that the above information is complete, true, and correct. Lost Valley Properties has my expressed consent to verify the accuracy of the statements, to communicate with any employers or creditors to attain information needed to evaluate this application. I have read and understand the lease and provisions attached to the lease.

Applicant Digital Signature

Date *

Co-signer Digital Signature

Date *

Check this box if you wish for Lost Valley Properties to share your contact information with other potential clients. This will be used to assist you in finding a roommate. It is not our policy to match roommates, however we will allow you to contact other potential clients which are also looking for roommates.

Rental Preferences

Personal Information

Permanent Address

Emergency Contact Information

Residence History

Employment History

Other Information

Co-signer Information

You can also contact us at: