West Virginia Rental Application

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WEST VIRGINIA RENTAL APPLICATION
Property Applying For: ______________________________
Requested Move-In Date: ______________________________
Last Name: _____________________First: ____________________Middle:____________
SSN: ____________________ Drivers License: _____________________________
Date of Birth: ____________________ Phone #: __________________________
Text Service on Cell Yes No Cell #: __________________________
Email: _____________________________________________________________________
Current Address: ____________________________________________________________
City ____________________________ State: __________Zip: ____________
Landlord: _____________________________ Phone # ________________
How long? From: ______________To: ___________ Current Payment: ________________
Reason for Leaving:____________________________________________________________
Previous Address: ____________________________________________________________
City ____________________________ State: __________Zip: ____________
Landlord: _____________________________ Phone # ________________
How long? From: ______________To: ___________ Current Payment: ________________
Reason for Leaving:____________________________________________________________
Current Employment: _______________________________________________________
Street Address: _____________________________________________________________
City ___________________________ State: __________ Zip: _____________
Supervisor: ___________________________ Phone # ___________________
How long? From: ____________________________To: _____________________________
Income: ___________________________ per Week Month Year
Previous Employment: _______________________________________________________
Street Address: _____ _______________________________________________________
City ___________________________ State: ___________Zip: ____________
Supervisor: ____________________________ Phone # ________________
How long? From: ____________________________To: ____________________________
Income: ____________________________ per Week Month Year
List ALL additional occupants - include age of minor children.
Name: ___________________________Relationship: ___________________Age:_____
Name: ___________________________Relationship: ___________________Age:_____
Name: ___________________________Relationship: ___________________Age:_____
Name: ___________________________Relationship: ___________________Age:_____
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West Virginia Rental Application PDF

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