2400 MOUNTAIN DRIVE #103 HOOVER, AL 35226 PH: (205) 824-1459

ADDRESS OF RENTAL PROPERTY APPLIED FOR: ________________________________________

NAME: _________________________________________________ SOC SEC # ___________________

PRESENT ADDRESS: ____________________________________________ PH: ____________

RENT $ ______________ ____________________________________________ HOW LONG? ____

NAME OF APT OR OWNER ______________________________________ PH: __________________

FAX NO: __________________

PREVIOUS ADDRESS: ____________________________________________________________

RENT $ _____________ ___________________________________________ HOW LONG? ____

NAME OF APT OR OWNER ______________________________________ PH: _________________

WAS YOUR FULL SECURITY DEPOSIT REFUNDED? ___________ FAX NO: _________________

PREVIOUS ADDRESS: ___________________________________________________________

RENT $ _____________ ___________________________________________ HOW LONG? ____

NAME OF APT OR OWNER ______________________________________ PH: _________________

WAS YOUR FULL SECURITY DEPOSIT REFUNDED? ____________ FAX NO: _______________

HAVE YOU EVER BEEN EVICTED? _______ FROM WHERE AND WHEN? __________________

____________________________________________________________________________________

HAVE YOU EVER BEEN CONVICTED OF ANYTHING OTHER THAN TRAFFIC VIOLATIONS?

IF SO, EXPLAIN _____________________________________________________________________

ARE YOU UNDER A RESTRAINING ORDER OF ANY TYPE? IF SO, EXPLAIN _______________

____________________________________________________________________________________

PETS? (Y/N) ________ HOW MANY? __________ TYPE ________________________________

LIST THE NAMES AND AGES OF EACH PERSON WHO WILL LIVE HERE:

NAME AGE NAME AGE

__________________________________ ____ _________________________________ ____

__________________________________ ____ __________________________________ ____

__________________________________ ____ _________________________________ ____

__________________________________ ____ __________________________________ ____

__________________________________ ____ _________________________________ ____

WORK INFORMATION:

PRESENT EMPLOYER ________________________ HOW LONG? ________ PAY/MO $__________

SUPERVISOR ____________________________________________

PH NO: ______________________ FAX NO. _______________________

PREVIOUS EMPLOYER ________________________ HOW LONG? _______ PAY/MO $__________

SUPERVISOR ____________________________________________

PH NO: ______________________ FAX NO. _______________________

CREDIT INFORMATION:

BANK _______________________________________________ PHONE _______________________

CHECKING ACCT # _________________________ SAVINGS ACT # _________________________

CASH ON HAND AND IN BANKS $ ______________________

HAVE YOU EVER DECLARED BANKRUPTCY? ________________ WHEN? _________________

WERE ALL CREDITORS EVENTUALLY PAID? ______________

AUTOMOBILE INFORMATION:

CAR MAKE ________________________ MODEL ______________________ YEAR ______________

FINANCED WHERE? ____________________________________________ PH: __________________

The above statements are accurate. By signing this application I authorize credit and rental reference checks. I am paying $30.00 as a credit check fee and I understand that this fee IS NOT REFUNDABLE, whether I rent from Stringfellow Properties or not.

I certify that all of the above information is correct and true and I understand that purposely rendering false information is a violation of Alabama State Law and may lead to criminal prosecution and/or eviction.

Agent that showed you this property ___________________________________

SIGNED: _________________________________________________ DATE: __________________