Rental Application - Diversified Property Management is a  Equal Housing Opportunity

WHERE DID YOU FIND US?

1:   [  ] Flier: Where?_____________   [  ] ForRent.com         [  ] Rent.com   
[  ] Newspaper: ______________    [  ] Apartments.com    [  ] 411 Magazine   [  ] Other______________

2:    
Property Address: ______________________________________________________________

3:  Anticipated move date of ___________at a monthly rent of $_________ plus cable [ Y ]  [ N ]  plus

security deposit of $_________ plus last month’s rent $_________. Total move-in cost $__________.

PLEASE TELL US ABOUT YOURSELF
Full Name_____________________________________________ Home Phone
(__________________        __________________
Date of Birth_________________________________Social Security#______________________________

Email Address:__________________________________________   Other Phone (       )
___________________
Co-Applicant Name_________________________________________ Names of  

Dependents____________________________________________________________________________

Co-Applicant Date of Birth___________________

Social security #__________________________________________

Dependents
Date Birth_____________________________________________________________
Pets__________________________________________________________________________________________

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address: _______________________________Apt#________ City__________________
State______ Zip________
Month/Year Moved In______________________ Reasons for Leaving
____________________________Rent $__________
Owner/Agent__________________________________________________Phone (       )
____________________________
Previous Address (last 3 years)____________________________________________Rent$____________

Owner/Agent__________________________________________________Phone___________

PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you ever committed a misdemeanor or felony offense?
If yes, what offense?___________________________________________        Yes___________
No____________
Have you ever been evicted from a rental residence?        Yes___________ No____________
Have you had two or more late rental payments in the past year?        Yes___________ No____________
Have you ever willfully or intentionally refused to pay rent when due?        Yes___________
No____________

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Your Status:  _____Full Time _____Part Time _____Student _____Unemployed   

Employer______________________________________________________________________________________________

Dates employed_______________________________ Employed

as______________________________________________

Supervisor Name______________________________________________ Phone (        )
______________________________

Salary $_________________per________________. TOTAL MONTHLY INCOME: $______________

If employed by above less than 12 months, give name & phone of previous employer or school:
___________________________

If you have other sources of income that you would like us to consider, please list income, source, and
person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony,
child support, or spouse's annual income unless you want us to consider it in this application.
Amount $___________________ Source/Contact
Name__________________________________________________________

PLEASE LIST YOUR REFERENCES
Banking  Accounts:
Name_________________ Type of Account_________________ Account Number_________________
Name_________________ Type of Account_________________ Account Number_________________

Personal Reference or Emergency Contact:
Name _____________________ Address ____________________________Phone ______________

Relationship__________

Name _____________________ Address ____________________________Phone ______________

Relationship__________

Vehicle Information:

Your Driver's License Number_________________ State_________________


Make / Model _________________Year _________________License Plate State_________________

Authorization Release of Information: I Authorize Diversified Property Management whose address is      
3750 Cedar Ave.  Minneapolis, Mn. 55407 and Multi housing Credit Control Whose address is 10125
Crosstown Circle, Suit #100, Eden Prairie, MN 55344 to investigate criminal history, residential,Employment,
and  income history, bank and credit history for the purpose of housing and/or employment. The source of
information may come from, but is ;not limited to credit bureaus banks and other depository institutions  
current and former employers federal or state records including employment security agencies records count
or state records as fallows, or other course Require fit is understood that a photocopy or facsimile copy of  
this form will serve as authorization.I understand failure to complete this form completely  and truthfully may
result in denial and/or forfeiture of Deposit this authorization is for this transaction only and continues in
effect for one (1) year unless by state law,in which case the authorization continues in effect for the maximum
Period not to exceed one (1) year,allowed by law.





_____________________________________________
Name's (please print)

X_______________________________________       __________________________
Signature                                                                                 Date

X_______________________________________       __________________________
Signature                                                                                 Date