Office Use ONLY

	Made Copy of Picture I.D. & Checked SS Card
	Application Fee Paid
	Applicant Approved or Denied
	Reason for Denial

RENTAL APPLICATION

Connelly Properties LLC

710 Patton Circle Unit #13

Winterville, NC 28590                                       

Ph: (252) 756-4376 | Fax: (252) 565-8026

Web: www.connellypropertiesnc.com

EVERY LINE TO BE FILLED UPON COMPLETION

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*Please include an application fee of $30.00 made payable to Connelly Properties.  (Cash/money orders accepted)

*If you are mailing your application, include a copy of your Picture ID, when you arrive you will need to present your SS Card.  If you do not have a copier you can present your ID when you come to Connelly Properties.

*Person filling out application must be truthful and fill out every line.

*Each applicant intending to be on the lease needs to fill out a separate application and pay additional App. Fee.

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General Information

First Name______________________­­­­­______ Last Name___________________________ M.I._______

Cell Phone #________________Home Phone #______________E-mail Address____________________

Driver’s License #___________________________________________________________ State______

Present Street Address__________________________City_________________________Zip_________

How long have you lived at the above address? _____________________________________________________________________________________

On the back of this application list all addresses you have lived at in the past 5 years. (Include street #’s,

street names, cities, states and zip codes ---start with the most recent)**

Social Security #______________________ Marital Status_____________ Date of Birth_____________

Spouse’s First Name___________________ Spouse’s Last Name____________________ M.I.________

Spouse’s Social Security # _______________________Spouse’s Date of Birth _____________________

Do you have a Bank Account? _________ Name of Bank______________________________________

Do you have a Credit Card? __________Name of Credit Card Company___________________________

Employment Information

Current Employer______________________________________________________________________

Employer’s Phone Number ____________________________City___________________ State_______

Your Position_______________________________________________________ Duration___________

Monthly Income from Job $_____Other Monthly Income (Specify) $_____Total Monthly Income $____

Other Important Information

Name of Previous/ Present Landlord/ Property Management Company____________________________

City________________________ State_______ Phone Number _________________________________

How many other occupants will be living with you? _________ List all full names and relation _____________________________________________________________________________________

Will you have any pets on the premises? ____ Number of Pets ___ Breed____________ Weight_______

Have you ever been convicted of an offense? _____ If yes, what? ______________________________

Year______(If you mark “No,” and we find you were convicted of an offense, you will automatically be denied.)

What rental are you interested in? ________________I would like to move no later than______________

I heard about Connelly Properties from? ____________________________________________________

Do you have Facebook? _______ Do you have Twitter? ________ Do you have Myspace? _________

Applicant’s Signature________________________________________________    Date_____________

Your signature authorizes Connelly Properties to check your credit.