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Application

Horizon Rentals Online Application

Seperate application required from each applicant age 18 or older.
INCOMPLETE APPLICATIONS WILL BE DENIED.

Prospective Address

Budget

House or apartment/Number of bedrooms desired

Full name - include all names used *

Home phone

Cell phone *

Email:

Date of birth

Vehicle make

Vehicle model

Vehicle color

Vehicle year

License plate number/state

Additional occupants

List full names, ages and relationship to you of everyone who live with you at least 50% of the time

Rental History – Current address

Dates lived at this address

Reason for leaving

Landlord

Landlord's phone

Miscellaneous

Describe the number of pets (if any) you want to have in the rental property. Not all properties will allow pets.

Do you smoke?

Yes
No

Have you ever filed for bankruptcy?

Yes
No

Have you ever been sued?

Yes
No

Have you ever been evicted?

Yes
No

Have you ever been convicted of a crime?

Yes
No

Explain any "Yes" answers from above

1. Personal reference

First

Last

1. Relationship

1. Address

1. Phone

2. Personal reference

First

Last

2. Relationship

2. Address

2. Phone

Emergency contact

First

Last

EC. Relationship

EC. Address

EC. Phone

Employment history - Name of current employer

Employer address

Employer phone

Name of supervisor

Supervisor's phone

Dates employed

Position or title

Name of previous employer

Previous employer address

Previous employer phone

Name of previous supervisor

Previous supervisor's phone

Dates previously employed

Previous position or title

Income – Gross monthly employment income (before deductions)

Average monthly amounts of other income (specify sources)

Other income sources

Total income

Credit accounts & loans – credit card

Name and monthly amount

Credit card

Name and monthly amount

Loan (specify type)

Name and monthly amount

Other major obligations

Name and monthly amount

I certify that all the information given above is true and correct. I understand that my lease or rental agreement may be terminated if I have made any false or incomplete statements in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords, employers and references. *

I agree

Signed *

Date *

Notes to landlord

Lighthouse Hospitality

Contact

Phone

eMail

lodginginfo@lighthousehannibal.com

Address

111 Bird Street
Hannibal, MO 63401