Rental Application – Cosigner/Guarantor

Please enter information on this form to submit a Rental Application – Cosigner/Guarantor. The application fee amount you need to pay is $25.00.

First name and M.I.*
Last name*
Current Address*
Current Address 2
Current City*
Current State*
Current Zip*
Phone*
Secondary Number
Email*
Fax #
Social Security #*
D.O.B*
Driver's License Number
Driver's License State (e.g. ME)
Who You are Cosigning For?*
Cosigner's Residency Information
(If you own your own home, please fill in all info. indicating self as landlord.)
Rent/Mortgage
Utilities Included
Landlord
Landlord's Phone #
Cosigner Employment History
Salary*
Salary Frequency*
Place of Employment
Occupation
Supervisor
Supervisor Phone Number
Start Date
General Questions
Have you ever been evicted? *
If you have been evicted, please explain why.
Electronic Signature
I do hereby certify that the information on this application is correct and complete to the best of my knowledge. I do hereby authorize Port Property Management, any of its staff and/or an authorized representative to contact any prior or current employers, companies, credit bureaus, law enforcement agencies and/or consumer reporting bureaus, including but not limited to RealPage, Inc. I understand that the $25 application fee is non-refundable. If a guarantor application is denied, there is a non-refundable $25 fee for each additional guarantor application. I authorize and consent to the permanent recording and retention by RealPage, Inc. of this application. However, this application and the information herein may only be re-published and released upon my subsequent written or electronic authorization and only to a third party I specifically designate. I release and hold RealPage Inc. harmless from any and all liability for said acts provided these conditions are met.
I/We do hereby certify that the information on this application is correct and complete to the best of my knowledge. I/We do hereby authorize Port Property Management, any of its staff and/or an authorized representative to contact any prior employers, companies, credit bureaus, law enforcement agencies and/or consumer reporting bureaus, including but not limited to Real Page, Inc. I understand that the $25 application fee is non-refundable. I authorize and consent to the permanent recording and retention by RealPage, Inc. of this application. However, this application and the information herein may only be re-published and released upon my subsequent written or electronic authorization and only to a third party I specifically designate. I release and hold Real Page, Inc. harmless from any and all liability for said acts provided these conditions are met.
I agree to the above*
Yes  
Payment Information
Credit Card Number*
Expiration Date* /
Card (CVV) Code*

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