Application – Big Country Real Estate

What property are you applying for?

Applicant

Name Of Applicant

First

Last

Date Of Birth

Phone Number

Email Address

Social Security Number

Driver's License

Click or drag a file to this area to upload.

that Social given

Co Applicants

Co Applicant

First

Last

Date Of Birth

Phone

Social Security Number

Driver's License Number

Residence History

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

How long have you lived here?

Landlord Name

Landlord Phone Number

Reason for Moving

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Landlord Name

Landlord Phone Number

How long did you live here?

Have you ever been evicted?

Yes
No

Have you ever broken a lease?

Yes
No

Employer

Current Employer

Job Title

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Name of Supervisor/HR

Company Phone

Years Employed

Monthly Income

Other Sources Of Income

Amount of Income

List All Other Occupants at the Property

Name

First

Last

Age

Relationship

Vehicles to be Parked at Property

Vehicles

Vehicle Make / Model / Year

Vehicle Color

License Plate Number

State

Do you have any pets?

Yes
No

Do any of the occupants smoke?

Yes
No

Have you ever been convicted of a crime?

Yes
No

Have you ever declared bankruptcy?

Yes
No

Personal References

Repeater

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Relationship

Phone

Repeater #2

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Relationship

Phone

By checking this box, I certify that all the above information, to the best of my knowledge is true. My typed name gives Big Country Real Estate LLC permission to verify all given information.

I Consent

Signature

Clear Signature

Application Fee

Application Fee – $35