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a ¥ \ Date of Occupancy KCK PROPERTIES Unit Address Referred by RENTAL APPLICATION ‘rst Name Last Name Social Security # Current Address City State Zip Landlord Landlord Phone; Rent Lease dates Other occupants Social Security # Email Phone Relationship PREVIOUS RESIDENCE HISTORY Address city State Zip Landlore Landlord Phone Rent. Lease dates PERMANENT ADDRESS (if not current address) Address Gity State Country Zip EMPLOYMENT INFORMATION (During Lease Term) Employed (circle) Full-Time Part-Time Unemployed Retired Employer Supervisor Employer Address Phone Position Held Department If Student (circle) Undergrad Grad Student List Schoo! (2 EMERGENCY CONTACT or 1 COSIGNER INFORMATION Name Relationship Phone Email Address, Gity State Zip Do you own any pets? (*See Rule #6) LI No LI YES, what kind of pet? ALL THE FOLLOWING QUESTIONS MUST BE ANSWERED PRIOR TO PROCESSING THIS APPLICATION Has an eviction action ever been filed against you ? ONO

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