Eau Claire Rentals

Eau Claire Rentals Online Residential Application

Each person, over the age of 18 years, who intends to reside in this rental unit must submit a separate Rental Application. If your application is approved, and your move-in is not immediate, a security deposit and first months rent will be collected at the time the lease is signed. A security deposit will not be accepted until the Rental Application is approved.

*Required Fields*

Address or Unit Number applying for: *

Please enter the names of other persons applying:

If you were given a reference number please enter it here:

Name: * Date of Birth: *

Drivers Licence #: * State: *

Daytime Phone#: Cell Phone#:

Evening Phone#: Email Address: *

How many people will reside at this unit? How many over the age of 18?

Who would we contact in case of an emergency? Phone#:

Current Address: * How long at this address: *

City: * State: * Zip: Rent amount/mo.:$ *

Landlord: * Phone:

Is your lease expired: If not, When? Reason for move:

Previous Address: How long at this address:

City: State: Zip: Rent amount/mo.:$

Landlord: Phone:

Employment Status: (check all that apply)*

Full Time Part Time Full time Student Part time Student Unemployed

Employer: How Long: Annual Income:$

Reference: Phone:

Previous Employer: How Long:

Reference: Phone:

Have you ever been the subject of an eviction proceeding or settlement?

If yes explain:

Have you ever been charged with a felony or drug related charge?

If yes explain:

By entering full name and clicking this checkbox the applicant agrees to all terms set forth on this application.

Full Name: I agree to all terms *

The Applicant declares that the information contained in this Rental Application is true, complete and correct, and understands and agrees that any false statements or representations identified herein may result in rejection, without further notice. The applicant specifically authorizes and directs any and all persons or entities named by Applicant herein to receive, provide, and exchange with Jason Manz Construction(Eau Claire Renals), it’s principals, agents and employees, any information pertaining to applicant, including but not limited to confidential information pertaining to credit and payment history, the opinions and recommendations of personal and employment references, and rental history. The Applicant hereby waives any right of action now or hereafter accruing against any person or entity as a consequence of the release or exchange of such confidential information.