Application To Lease

Note: Use the browser print function to print this application. Use the browser "back arrow" to return to the previous page. Upon completion, there are 2 options; 1) mail or drop the application off, along with the fee, at the Dazcon office in Mooresville; or, 2) fax the Application along with a completed Credit Card Authorization Form to the Dazcon office. Click here to print the Authorization Form.

Application to Lease

Important !! We must have your contact phone number:_________________

Property: __________________________________ Date: ________________

Applicant Information

Name:__________________________ Date of Birth: _____________ SS#: _________________

Email:__________________________ Drivers License # : __________________ State: _______

Spouse:_________________________Date of Birth: _____________ SS#: _________________

Email:__________________________ Drivers License # : __________________ State: _______

List below all persons to occupy residence:

Name

Relationship

Date of Birth

Name

Relationship

Date of Birth

1

4

2

5

3

6

Will there be any smokers living in this residence? Yes No

Will smoking be allowed inside this residence, by residents or others? Yes No

List below any pets

Kind

Weight

Color

Age

Inside/Outside

1

2

3

Resident History

Current Address:________________________________ City: _______________ State: ______ Zip: ________

Own

Rent Dates From: _________ To:________ Phone: _______________ Monthly Rent? ____________

Current Landlord or Mortgage Company: ______________________________ Phone: _____________

Reason for moving: ___________________________________________________________________

Previous Address:________________________________ City: _______________ State: ______ Zip: _______

Own

Rent Dates From: _________ To:________ Phone: _______________ Monthly Rent? ____________

Previous Landlord or Mortgage Company: _____________________________ Phone: _____________

Reason for moving: ____________________________________________________________________

Have you ever been evicted from any leased properties (Y/N)? ________________

Employment / Income

Present Employer:_____________________________________ Position:___________________________

Address:_____________________________________________ Supervisor:_________________________

Phone:__________________ Salary:___________________ Employed From:__________ To:_____

Previous Employer:____________________________________ Position:___________________________

Address:_____________________________________________ Supervisor:_________________________

Phone:__________________ Salary:___________________ Employed From:__________ To:_____

Spouse's Employer:____________________________________ Position:___________________________

Address:_____________________________________________ Supervisor:_________________________

Phone:__________________ Salary:___________________ Employed From:__________ To:_____

Additional Income: ______________________ Source:______________________________________

I/We hereby make application for the above-described property. With the execution of this application, I/We have paid a non-refundable application fee of $ 40.00 to Dazcon Properties to cover the cost of a credit check and processing fees. By signing this form, I/We grant authority to the lessor or his agent to perform a credit check and/or background check and investigate any of the above information. I/We certify the information disclosed on this application to be true and correct, and that misrepresentation or false information may result in the immediate denial of application or termination of lease.

Applicant Signature:____________________________________ Date:_________________________

Spouse's Signature:____________________________________ Date:_________________________