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Liz Brazil
Realtor, Jamestown, Rhode Island
Jamestown Rental Realty
Jamestown, RI 02835
(401) 423-1717    

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CLICK HERE to download a copy of the Winter / Yearly RENTAL APPLICATION

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If you prefer, you can fill out this application online, then print this page using your browser's print function and fax it to me at 401-423-1717.

Jamestown Rental Realty
WINTER / YEAR AROUND RENTAL APPLICATION
House "Name": Rental Dates Needed:
Applicant: Co-Applicant:
Address: Address:
Phone: Phone:
Drivers license: Drivers license:
1. CURRENT EMPLOYMENT (Applicant) 2. CURRENT EMPLOYMENT (Co-Applicant)
Company: Company:
Supervisor: Supervisor:
Date Started : Date Started :
Position Held: Position Held:
Monthly Salary: Monthly Salary:
Phone:    Ext: Phone:    Ext:

3a. Rental references name:
Address:    Phone:

3b. Rental references name:
Address:    Phone:

Automobile(s) Make: Year: Registration:

Automobile(s) Make: Year: Registration:

LEGAL NAMES OF ALL PERSONS WHO WILL OCCUPY THE UNIT:

Name: Name:
Name: Name:
Name: Name:
Name: Name:

Pets, breed, age & weight:

Applicant hereby authorizes verification of all references and credit. Any misrepresentation will disqualify the applicant. It is further understood that in the event the Landlord accepts the rental under the terms and conditions agreed, but the prospective tenant decides not to rent, the rent will be forfeited. If however the Landlord does not agree to rent under the terms and conditions as agreed to, the prospective tenant will receive a full refund of the rent.

_____________________________________
Applicant Signature		 _____________________________________
Co-Applicant Signature
Date: Date:
Social Security #: Social Security #:
Date of Birth: Date of Birth:

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