Pfaff Properties, LLC
5195 W. Main Street, PO Box 105, Ireland, IN 47545

Application for Lease and Credit Check

First name

Middle name

Last name

Date of Birth

Phone Number

Social Security Number

Marital Status

Smoker

Yes

Have Pets?

Yes

How many

Kind

Which property are you interested in?

Number of Bedrooms

Number of Bathrooms

Present Address

How Long?

Rent Paid

Moving Reason

Names of people living with you

Landlord Name

Landlord Phone

Landlord Address

Have you ever been evicted?

Yes

if yes, explain

asdf

Employer

Phone

Position/Department

Supervisor

Start Date

Gross Monthly Salary

List 3 Emergency contacts not living with you

Name

Relationship

Phone

Name

Relationship

Phone

Name

Relationship

Phone

I hereby give permission to access my current financial credit report.