Jacksonville Rentals, LLC
5300 San Juan Ave. Jacksonville, FL 32210
www.rentsjax.com
Office: (904) 693-6092, Fax: (904) 388-1763
APPLICATION FOR RESIDENCY
PLEASE TELL US ABOUT YOURSELF
LAST
APPLICANT
MIDDLE
MARITAL STATUS
FIRST
DATE OF BIRTH
PRESENT PHONE
SOCIAL SECURITY #
DL#
9:00-5:00
CONTACT #
Have you ever had an eviction filed
Pets (Keeping of pets requires pet fee and owner’s consent)
against you?
YES
NO
Breed
Age
Weight
Name
Apt #
City
State
zip
rent/mortgage payment
OWN
Since
Present Street #
RENT
Address
Address
City
State
Zip
Phone No
Landlord Name
Mtg. Co.
Name
Apt #
City
State
zip
rent/mortgage payment
OWN
Since
Previous Street #
RENT
Address
Have you or any occupants ever been arrested for, convicted of, put on probation for, or
If, yes, please explain
had adjudication withheld or deferred for a felony offense? YES NO
PLEASE TELL US ABOUT YOUR JOB
Name
Business Address
City
State
Zip
Phone No
PRESENT
EMPLOYER
Position
Supervisor
PREVIOUS
EMPLOYER
Position
Monthly Income
Name
From
Business Address
Supervisor
City
State
Monthly Income
To
Zip
Phone No
From
To
PLEASE GIVE US THE FOLLOWING INFORMATION
Emergency Name
Contact
Automobile Year
#1
Name
Children
Occupying
Name
Bank
Ref
Full Address
Make
Model
Age
Color
Tag #
Name
Phone No
Automobile Year
#2
Age
Location
Make
Name
City
Model
Color
Tag #
Age
State
Applicant agrees that false, misleading or misrepresented information will result in the application being rejected, will void a lease/rental
agreement if any and/or be grounds for immediate eviction with loss of all deposits and any other penalties as provided by the lease terms if any.
Applicant has the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and
scope of this investigation. NON REFUNDABLE APPLICATION FEE- Applicant(s) has paid to Owner/Agent a NON REFUNDABLE
APLLICATION FEE for costs, expenses and fees in processing the application. HOUSE DEPOSIT AGREEMENT- Applicant has
deposited a “HOUSE DEPOSIT” in consideration for taking the dwelling off the market. If applicant is approved by Owner/Agent the
HOUSE DEPOSIT shall be applied toward the security/damage deposit. If applicant is approved, and the applicant changes their mind after
48 hours of signing the application, the FULL HOUSE DEPOSIT shall be FORFEITED to the landlord. If the applicant fails to enter into
a lease agreement after verbal or written confirmation of a move-in date the full house deposit shall be forfeited to the landlord. The
deposit will be refundable if applicant is denied or cancels application within 48 hours of signing your application and deposit with us. Keys will
be furnished only after the lease and other rental documents have been properly executed by all parties and only after applicable rentals and
security deposits have been paid. This application is preliminary only, in no way implies that a particular rental unit shall be available and in no
way obligates Owner/Agent to execute a lease or deliver possession of the proposed premises.
I HAVE READ AND AGREE TO THE PROVISIONS AS STATED
____________________________________
Applicant Signature
______________
Date
OFFICE USE ONLY/ MONIES PAID
$ _______________ for ___________________________
$ _______________ for ___________________________
Address:____________________________ Move-in Date ________
Rent :
____________
Application Fee: __________
Deposit: _____________
Pet Fee: _________________
$ _______________ for ___________________________
$ _______________ for ___________________________
How Did You Hear About Us? ______________________________________________________________
Email Address: _______________________________________
Jacksonville Rentals, LLC
5300 San Juan Ave. Jacksonville, FL 32210
www.rentsjax.com
Office: (904) 693-6092, Fax: (904) 388-1763
RENTAL CRITERIA
1.
2.
3.
4.
Applicant must have a good credit rating.
Applicant must have a favorable rental reference.
Applicant must show proof of income.
Applicant’s gross monthly income must be at least three times the monthly
rental rate for the house selected.
5. Owner/Agent reserves the right to require applicant to pay additional security
deposit if they do not meet the above criteria.
6. Applicant and any occupants over the age of 18 will be subject to a criminal
background check. Applicant and occupant(s) must not have a criminal
background including, but not exclusive to, felony and misdemeanor charges for
illegal drugs, burglary, felony or petty theft, vandalism, sex offenses, habitual
battery offenses, etc. resulting in the following adjudication: conviction, nolle
prossed, withheld, declined to prosecute, etc.
7. Applicant must not have more than 2 persons residing in a one bedroom house;
not more than 4 persons residing in a two bedroom house; not more than 6
persons residing in a three bedroom house.
8. Applicant must be of legal age (18).
9. Applicant understands that application fees are non-refundable. Security
deposits are refundable upon cancellation within 48 hours of application,
otherwise forfeited. Rejected applicants will be refunded only the security
deposit, not the application fee.
10. A $300.00 non-refundable pet fee is required for each pet. Only cats and dogs
with a 50 lb weight limit will be accepted. Certain breed restrictions. A pet rent
of $25 per month is also required for each pet.
11. All monies must be in the form of cashiers check, cash or money order.
12. Photo I.D. must be presented at time of MOVE-IN.
I have read and understand the criteria from which my application will be
approved.
______________________________
Applicant Signature
________________
Date
______________________________
Applicant Signature
________________
Date
Jacksonville Rentals, LLC
5300 San Juan Ave. Jacksonville, FL 32210
www.rentsjax.com
Office: (904) 693-6092, Fax: (904) 388-1763
AFFIDAVIT
(Addendum to Application)
I, ______________________, the undersigned applicant freely and voluntarily authorize verification
of any and all information set forth on documentation relating to this application, or release of any
other information relating to this application, including release of information by any creditor or
employer. In addition, I voluntarily consent to a criminal background investigation, and release of
any information pertaining to arrest or conviction, and hereby authorize JACKSONVILLE RENTALS,
LLC to obtain my consumer credit file from any source.
The applicant understands and herby acknowledges the information referred to above, or certain
portions thereof, may be protected from disclosure without this signed authorization by federal and
state laws.
Applicant represents that the information set forth on this document or any other document related
to this application is true and complete. The applicant understands that this an official document
governed by state and federal laws.
________________________
Applicant Signature
________________________
Date
__________________________
Witness Signature
YOU MUST COMPLETE THIS PORTION OF THE AFFADAVIT, PLEASE WRITE CLEARLY.
_____________________
SS NUMBER
_______________________
DATE OF BIRTH
_____________________________
Maiden Name (if applicable)
________________________________________________
Present Address
________________________________________________
City, State, Zip