Layne Real Estate Services, Inc.
914 South Main St.
P.O. Box 2814
Franklin, KY 42135
1-888-756-7171
270-586-7171
Fax:270-586-1718

Email Layneland@layneland.com

Thank you for your interest in the Layne apartment homes. Please fill out the form below and bring/mail it to our offices.
Thank you for your interest!

Rental Application

A $25.00 non-refundable application fee is required for investigation.

Instructions: A seperate application must be filled out by each applicant (even if married). Completely fill out each blank and sign where indicated.

PERSONAL

Applicant_______________________________________

Marital Status ___Single ___Married since (date)_____ Divorced since (date)______ Former Spouse________

Birth Date___________ SS#_________________ Drivers License State Issued By_________#____________

ADDRESSES

Present Address_______________________ City/State/Zip_________________ Since______ Rent/Month_____

Present Phone___________

Present Landlord________________ Address_________________ City/State/Zip________ Phone__________

Is Present Rent Up To Date?________ Have You Given Notice?_______ Have You Been Asked To Leave?_____

Previous Address___________________ City/State/Zip____________________ Phone_________________

Was Previous Rent Up To Date________ Had You Given Notice?_________ Were You Asked To Leave?______

Next Previous Address_________________ City/State/Zip__________________ Phone_________________

Was Next Previous Rent Up To Date?_____ Had You Given Notice?________ Had You Been Asked To Leave?____

OCCUPANTS

Number To Occupy_____

Name _______________________ Relationship____________________ Birth Date__________________

Name _______________________ Relationship____________________ Birth Date__________________

Name _______________________ Relationship____________________ Birth Date__________________

Name _______________________ Relationship____________________ Birth Date__________________

Pets:____Yes _____No If yes, give details. (Number, size, type)

CARS

Make/Model #1______________________ License Plate________________ Lien Holder#1_________________

Make/Model #2______________________ License Plate________________ Lien Holder#2_________________

EMPLOYMENT

Employer________________ Since__________ Previous Employer__________________ Since___________

Street/City_____________________________ Street/City___________________

What Do You Do?_____________________ What Did You Do?__________________________

Current Supervisor_______________________ Wrk Hrs._________ Phone________________

Previous Supervisor_____________________ Wrk Hrs._________ Phone__________________

INCOME

Current Income $_________________ Weekly/BiWeekly/Monthly/Yearly Source_____________________

Current Income $_________________ Weekly/BiWeekly/Monthly/Yearly Source_____________________

Current Income $_________________ Weekly/BiWeekly/Monthly/Yearly Source_____________________

Bank/Credit Union________________ Acct.#______________

Bank/Credit Union________________ Acct#______________

REFERENCE

Relative_________________ Relation_________ Non Releative Reference_______________ Phone___________

Address_________________ Phone___________ Address_______________________________________

Non Relative Reference____________________ Phone__________________

Emergency Contact_________________________ Phone_________________

CREDIT ACCOUNTS

Current (open) include credit cards

Name_________________ Address___________________ Acct. #______________ Payment_______ Current?____

Name_________________ Address___________________ Acct. #______________ Payment_______ Current?____

Name_________________ Address___________________ Acct. #______________ Payment_______ Current?____

Name_________________ Address___________________ Acct. #______________ Payment_______ Current?____

Explain any yes answers on back with names and details

Has any signer ever been sued for bills?____Yes ____No Has any signer ever been sued for eviction?____Yes ___No

Has any signer ever been bankrupt?___Yes ____No Has any signer ever been guilty of a felony?___Yes ___No

Has any signer ever broken a lease?___Yes ____No

Is total amount available now (rent plus deposit)?____Yes ____No

Name in which utilities are now billed and account number?_______________________#______________________

Applicant authorizes the owner to contact past and present landlords, employers, creditors, credit bureaus, neightbors and any other sources deemed necessary to investigate applicant.

All information is true, accurate and complete to the best of the applicants knowledge. Owner reserves the right to disqualify tenent if information is not as represented.

ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THEIS FORM OR A PHOTOCOPY OF THIS FORM AT ANY TIME

Signed________________________________ Date_____________________________
Applicant

Please fax or mail this application to
Layne Real Estate Services
P.O. Box 2814
Franklin, KY 42134
Fax- (270) 586-1718