APPLICATION FOR RENTAL
                                  EACH ADULT APPLYING FOR UNIT MUST COMPLETE A SEPARATE APPLICATION.
PLEASE PRINT – ALL information must be completed. All blanks must be filled in. The decision to rent to you will depend in great
part on your verifiable income, rental history, and background check. Only clean, honest and responsible people, who pay rent on
time, need apply.
How did you find out about us? Sign___ Internet___ Friend___ Other______________________
For Property Address:______________________________________
How long do you think you may want to live at this location?   1 year____               1-3 years____           More than 3 years____
Are you interested in purchasing a home in the future?______________
Do you have two times the rent available today to put towards moving in? __________
Applicant Information
Name: __________________________________          Birthdate: _____________________                 
Soc.Sec.#: _______________________________        Driv. Lic.#: ______________________________
Home Phone: _____________________________        Cell Ph #: _________________________
Can you send and receive texts?_______
Work Phone: ________________________________E-Mail: __________________________________
What is the best way to communicate with you?_____________________________________________
Current and Previous Addresses
Present Address:_____________________________        City ___________________ST _________ZIP _____________
Owner/Manager:_____________________________        Ph #: _____________________Current rent: $ _______________
How long at this address? _____________________        When will you be ready to move?__________________________
When does the lease end? _____________________        Reason for Moving?____________________________________
Previous Address:____________________________         City ___________________ST _________ZIP _____________
Owner/Manager:_____________________________        Ph #: _____________________Rent: $ _______________
How long at this address?______________________        Reason for Moving?____________________________________
Previous Address:____________________________         City ___________________ST _________ZIP _____________
Owner/Manager:_____________________________        Ph #: _____________________Rent: $ _______________
How long at this address?______________________        Reason for Moving?____________________________________
Name and relationship of every person to live with you, even if only temporarily:
Name: ___________________________Relationship: _____________________Age:____________
Name: ___________________________Relationship: _____________________Age:____________
Name: ___________________________Relationship: _____________________Age:____________
Employment
Present Employer: ___________________________        Present Job Title: ______________________________
How long with this employer?__________________        Supervisor: ________________________Ph #: __________________
Gross Annual Income Last Year: $______________        Current Gross Monthly Income: $_________________________
Previous Employer:__________________________        Previous Job Title: ______________________________
How long with this employer? _________________        Supervisor: ________________________Ph #: ___________________
Other Sources of Verifiable Income (monthly)
Social Security: $____________________                Pension: $__________________________
Child Support:$_____________________                 Other:$____________________________
Banking Information
Bank: _____________________________        Acct #:______________________        Current Balance: $__________________
Credit Card Account #:____________________________________Exp Date:____________
Balance Owed: $_______________________Monthly Payment: $________________
Vehicle(s)
1) Make:__________________Model: ___________________Year:________Lic. plate #:_______________         ST: _______
1) Make:__________________Model: ___________________Year:________Lic. plate #:_______________         ST: _______
List All Current Expenses (monthly)
Vehicle 1 Loan Balance: $___________________         Vehicle 1 Loan Payment: $__________________
Vehicle 2 Loan Balance: $___________________         Vehicle 2 Loan Payment: $__________________
Personal Loan Balance : $         ___________________        Personal Loan Payments: $__________________
Child Care: $______________________                 Health Care: $ __________________
Utilities: $________________________                 Telephone: $ ___________________        Other: $____________________
Additional Information
Have you ever filed for bankruptcy? ____________Ever been evicted? ___________
Ever been convicted of a felony?_______________Ever had a dispute with a previous Landlord? _________________
Have you ever been accused of being a sexual predator? ________________
Pets Name: __________________________        Pets Breed? _______________
NOTE: No pets are allowed at any time on the premises without prior
Management consent and payment of fees - NO EXCEPTIONS
Do you have a waterbed?_______________        Brand name of vacuum you own? ________________
Your attorneys name:__________________        Your doctor’s name:___________________________
Musical instruments owned:_________________________________________________________
References/Emergency Contacts:
Name:________________________________Ph #:___________________________ Email: ______________________
Relationship:_____________________________________Address: _________________________________
Name:________________________________Ph #:___________________________ Email: ______________________
Relationship:_____________________________________Address: _________________________________
I declare that the application is complete, true and correct and I herewith give my permission for anyone contacted to release the
credit or personal information of the undersigned applicant to Management or their authorized agents, at any time, for the
purposes of entering into and continuing to offer or collect on any agreement and/or credit extended. I further authorize
Management or their Authorized Agents to verify the application information including but not limited to obtaining criminal records,
contacting creditors, present or former landlords, employers and personal references, whether listed or not, at the time of the
application and at any time in the future, with regard to any agreement entered into with Management. Any false information will
constitute grounds for rejection of this application, or Management may at any time immediately terminate any agreement
entered into in reliance upon misinformation given on this application.

Applicant’s Signature: __________________________________________        Date:_______________________
                                             In order for your application to be processed, it must be filled out thoroughly.
                                 Each applicant needs to provide a $35 application fee, a copy of their driver’s license,
                                                       and copies of their last two paychecks OR last year’s W-2 form.


                                                         REGATTA PROPERTIES, LLP, PO Box 291, Gotha, FL 34734
                                                                           Phone: 321-206-8931 Fax: 321-206-8932
                                                                                         www.regattaproperty.com