The Alpine Group, Inc. Rental Application

Thank you for your interest in our property! Be sure to read our Screening Criteria listed below in the addendum section before submitting your application. (if you have questions regarding our criteria, please call our office at 503-641-4620).

All adults age 18 and older are required to complete a separate application.

Agent is requiring payment of an Applicant Screening Charge of $45.00 - none of which is refundable unless the Agent does not screen the applicant. Application is valid for up to two weeks from date of receipt by Agent.

Address You Are Applying For

Address Applying For

Lease Information

Desired Move-in Date Number of Occupants Number of Pets

Personal Information

First Name Last Name Middle Initial Maiden Name

Home Phone Work Phone Cell Phone Email

Date of Birth Social Security # Drivers License # License State

How Did You Hear About Us?

Emergency Contact

Name Relationship Phone Email

Address

Occupants

Occupant 1

First Name Last Name Date of Birth Relationship

Address History

Address 1

Current Previous

Rent Own

Address City State Zip

From To Monthly Payment Landlord

Landlord Phone Landlord Email Landlord Type

Reason For Leaving?

Employment History

Employer 1

Current Previous

Employer Name Phone From To

Address

Supervisor Name Supervisor Title Supervisor Phone Supervisor Email

Gross Income Per Month Hourly Rate Avg. Hours Worked Per Month

Other Sources of Income

Income Source Monthly Amount Phone

Section 8 Info

If you will be receiving Housing Assistance - please complete the following information:

Agency County Technician Phone

Assistance Amount Beds Allowed Utilities Included

Pets

Pet 1

Male Female

Pet Name Type Breed Age / Weight Color

Service or companion? House Trained De-clawed Has Shots Fixed

Pet 2

Male Female

Pet Name Type Breed Age / Weight Color

Service or companion? House Trained De-clawed Has Shots Fixed

Pet 3

Male Female

Pet Name Type Breed Age / Weight Color

Service or companion? House Trained De-clawed Has Shots Fixed

Pet 4

Male Female

Pet Name Type Breed Age / Weight Color

Service or companion? House Trained De-clawed Has Shots Fixed

Vehicle Information

Vehicle 1

Make Model Year Color

Plate Plate State Payment Insurance Carrier

Vehicle 2

Make Model Year Color

Plate Plate State Payment Insurance Carrier

Vehicle 3

Make Model Year Color

Plate Plate State Payment Insurance Carrier

Vehicle 4

Make Model Year Color

Plate Plate State Payment Insurance Carrier

References

Name Relationship Address Phone

Questions

Have you (or any person you have named on this application) ever been evicted from a tenancy or left owing money?

Yes No

Do you or any of the members of your household have pending criminal charges, or ever been convicted of, plead guilty or no contest to, any criminal offense(s) or had any criminal offense(s) other than traffic infractions that were disposed of other than by acquittal or a finding of "not guilty"?

Yes No

Have you (or any person you have named on this application) ever filed for, or currently involved in a bankruptcy, been foreclosed on, or been a defendant in a civil suit?

Yes No

evictio Do you currently hold an DHS OMPP card?

Yes No

Have you ever been sued for damages to a rental property?

Yes No

Have you ever filed suit against a landlord?

Yes No

Have you ever filed bankruptcy?

Yes No

Are you a smoker?

Yes No

Addendum

View Tenant Screening Criteria

Agent may obtain a tenant screening or credit report which generally consists of:
1. Credit history including credit standing;
2. public records, including but not limited to judgments, liens, evictions and status of collection accounts;
3. information verification;
4. current obligations and credit ratings; and
5. criminal records.
Agent is requiring payment of an Applicant Screening Charge of $45.00 - none of which is refundable unless the agent does not screen the applicant. Application is valid for up to two weeks from date of receipt by Agent. I understand I have the right to dispute the accuracy of any information provided to the Agent by a screening service or credit reporting agency. I am aware that an incomplete application may cause delays or result in denial of tenancy. I certify the above information is correct and complete and hereby authorize you to make inquiries you feel necessary to evaluate my tenancy and credit standing (including, but not limited to credit checks). If Agent is requiring payment of an applicant screening charge, applicant acknowledges receiving a copy of or reading Agents Screening Guidelines. Any deposit paid to hold a unit is deemed non-refundable and will be transferred to the security deposit upon completion of the move-in process.

I have read and agree to the terms of this application and the Tenant Screening Criteria.

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