Applications – Dagenais Real Estate Inc

APPLICATION

Dagenais Real Estate, Inc. Application For Lot

Application for Lot

Approved by:

Date

Lot Number

Size of Home

Park Name

Name

Social Security No.

Date

Date of Birth

Email Address

Name & Ages of Children

Current Address

Present Telephone No.

Where Employed

Occupation

How Long?

Present Landlord:

Current Address

Nearest Relative/ Emergency Contact:

Current Address

Financial Institution Reference:

Circle Accounts Held:

List Automobiles Of All Occupants:

Vehicle One

Vehicle Two

Vehicle two

Vehicle Two

Vehicle two

Vehicle Three

Additional Automobiles List Information

List Your Total Income:

List Your Total Income:

List Three Local Personal References:

Reference One

Reference Two

Reference Three

Have eviction proceedings ever been filed against you?

Do you have (or have you ever had) any garnishments?

If you answered yes to either question, please explain:

*OUR PARK RULES DO NOT PERMIT PETS. YOU WILL BE EVICTED IF YOU AQUIRE A DOG OR CAT*

The undersigned applicant hereby applies to lease or rent your property. We warrant the accuracy of the information provided. The applicant hereby authorizes Dagenais Real Estate to check, without liability, all information listed on this application, including the useof a credit reporting service. The applicant hereby authorizes Dagenais Real Estate to check, without liability, local police department records including any information in regard to complaints from neighbors or other members of applicants jurisdiction, which resulted in a police officer being dispatched to investigate the incident.

Applicant claims that all information above is true and understands that falsification of this application will be cause for denial of renting or grounds for evictions should they become a tenant.

DATE

APPLICANT

It is against the law to discriminate against tenants on the basis of race, color, religion, national origin, sex, handicap, height, weight, or family status.

DAGENAIS REAL ESTATE INC.
1505 North Lincold Road
Escanaba MI 49829
906-789-9427