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Office 336.227.4467
Fax 336.227.4627
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Application:
USE BLACK INK AND PLEASE PRINT CLEARLY! VERIFY I.D. / SSN / ADDRESS INFO!
Applicant: ____________________________________________________
Drivers Lic. #/State: ____________________________________________
SSN#: ________/____/__________
DOB: ________/____/_________
Spouse: _____________________________________________________
Drivers Lic. #/State __________________________________________
SSN#: ________/____/_________
DOB: ________/____/__________
Present Address: ________________________________Rent Amt: $________
Reason for Leaving:__________________
City: _____________________ State: _______ Zip: __________
Your Home Phone: (___)____-____
Current Landlord: ________________________________ Phone: (___)____-____
Date From:_____ to:_____
Previous Address: ________________________________ Rent Amt: $ _________
Reason for Leaving:___________________
City: _____________________ State: _______ Zip: __________
Has an eviction ever been filed against you? Yes / No
Previous Landlord: Phone: (___)____-____
Date From:______to______
Present Employer:_________________ Phone #:(____)____-____
Position: __________________________________
Supervisor: _______________________________________
Date From:_____ to______
Gross Income: $ _____per week[ ]month[ ] yr[ ] Other Income:_______
Bank Name:__________________
Savings Acct. #:_________________
Checking Acct. #:________________
Spouse’s Employer:__________________ Phone #:(___)____-____
Position:_____________________________________
Supervisor: _______________________________________
Date From:_____to______
Gross Income: $_____ per week[ ]month[ ] yr[ ] Other Income: _______
Bank Name:_______________
Savings Acct. #______________
Checking Acct. #_______________
Others who will occupy premises: ______________________
Pets? Yes or No
Auto make:__________________
Year:_______
Tag #___________
Auto Make:__________________
Year:_______
Tag # _________
Other Vehicles? Yes or No
If I/We rent the unit, I/We understand my/our rental history including lease violations and information I/we provide on this
application may be reported to and maintained by National Tenant Network for up to 7 (seven) years after I vacate the
premises.
Applicant Signature: ______________________________
Date: ___________________________
Spouse Signature: _________________________________
Date: ____________________________________
“Time is on your side!”
PO Box 1483
1214 Turrentine Street (27215)
Burlington, N.C. 27216
Office: 336-227-4467
Fax: 336-227-4627
www.TimePropertiesToday.com
Real Estate Investments, Management, and Brokerage
Application fee: $35.00 Paid date: _____/_____/______
Property of choice: ___________________________________________, #__________
Rent Amount: ______________________
Deposit Amount: ______________________
Down-payment: ______________________
Balance due:
Prospective move-in date: _____/_____/______
NTN MEMBER NAME: ______________ACCESS NUMBER:______________
TELEPHONE: (___)____-_____ FAX:(___)____-_____
CONTACT:_____________ DATE:____/_____/_____
TIME:___:___ REPORTS FOR:(Please Specify) Applicant___ Spouse___
STATE or COUNTY CRIMINAL__ (Please Specify):___________
REPORT TYPE(S): CREDIT___ EVICTION___ NATIONWIDE CRIMINAL__ FULL SERVICE __ (Credit, Eviction, Local Criminal & Verify Employer / Landlord)
TERMS: APPLICANT CERTIFIES THAT ALL INFORMATION GIVEN TO EVALUATE
THIS APPLICATION TO RENT / LEASE IS CORRECT AND COMPLETE. APPLICANT
AUTHORIZES ALL INQUIRIES BY RENTAL OWNER OR OWNER’S AGENT OR
NATIONAL TENANT NETWORK DEEMED NECESSARY TO EVALUATE THIS
APPLICATION. APPLICANT FURTHER UNDERSTANDS THAT ANY FALSE ,
INACCURATE, OR INCOMPLETE INFORMATION IS GROUNDS FOR IMMEDIATE
REJECTION. APPLICANT SPECIFICALLY AUTHORIZES AND REQUESTS ALL PRESENT
AND PREVIOUS EMPLOYERS, MORTGAGE HOLDERS, LANDLORDS, RENTAL
AGENTS, CREDIT GRANTORS, BANKS, ACCOUNTANTS, STOCK BROKERS, AND ANY
GOVERNMENT AGENCY TO RELEASE ANY REQUESTED INFORMATION IN THE
EVALUATION OF THIS APPLICATION. THIS FORM IS PROVIDED BY NTN TO ASSIST
ITS MEMBERS IN PROCESSING THEIR APPLICATIONS TO LEASE RENTAL PROPERTY.
NTN SHALL NOT BE RESPONSIBLE FOR THE USE OR APPLICATION OF THIS FORM
BY OTHERS OR ANY LEGAL ASPECT AS TO A LEASING / RENTAL AGREEMENT
ENTERED INTO BY ANY PARTIES USING THIS FORM.
PREPAID RENT IS NON-REFUNDABLE!
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