Prairie View Home Rentals

 Prairie View Home Rentals

311 6th St. NE, PO Box 92,  Crosby, ND 58730

Email: kmande@nccray.com    Phone: 701-840-2428(Keith)

 Application for Monthly Guest Unit Rental

 Full Name ________________________________________________Birthdate __________________________

Permanent Address ___________________________________________________________________________

 Your current occupation ___________________________Contact Phone # ___________________________

 Email Address ______________________Vehicle(s) make and license # ________________________________

 Number of vehicles and vehicle size/type that you would want to park _________________________________

 Preferred start date _________________        Anticipated length of stay _____________________________

 Number of occupants for the unit _____    (Note that each adult occupant must fill out a separate application.)

 Name of any child under 18 who will also occupy the unit with their parent ___________________________

 Current Employer and contact information _____________________________________________________

 Personal References with phone numbers __________________________________________________

 __________________________________________________________________________________

 Person(s) to contact in an emergency with phone number(s)  _____________________________________

 __________________________________________________________________________________

 Do you use tobacco products? ____________

Have you ever declared bankruptcy? __________

Have you ever been evicted from a rental property? __________

Have you had any late rental payments in the last year? __________

Will you be able to pay rent on the day you move in? ____________

Have you ever been convicted of a crime, excluding traffic violations? ________   If yes, explain below:

 __________________________________________________________________________________________

 I declare that all of the above information is true and correct and the information may be used by the homeowner  to determine whether to accept or decline this application.  If any information provided by me is determined to be false, such false statements will be grounds for disapproval of my Application or termination of my Lease with the owner. I give permission to have my current and previous employers, my current or most previous landlord and listed references contacted to determine my personal character, ability to pay rent on a timely basis, and compatibility with current houseguests, the homeowner and his family.

 Applicant’s Signature ___________________________________     Date ____________________

 Note that by signing this application, I give permission for a local and national background check to be done on me.