Rick Pranada - Rental Application

Reily Investments, Inc.
Real Estate Acquisition, Sales & Management

Rental Application

Reily Realty & Management

4001 Pacific Coast Hwy. #114 Torrance, CA 90505

Phone: (310) 540 - 3290 Fax: (424) 304-2633

APPLICATION TO LEASE REAL ESTATE

(There is a $40.00 non refundable processing fee)

Location:

If joint application, please provide information for all parties signing lease agreement

Name:

Address:

Years at address:

Phone:

Social Security:

Birth date:

Drivers license #:

How long do you intend to occupy the property:

Do you have any water filled furniture:

Pets:

Current Employer:

How long:

Address:

Phone:

Income:

Bank:

Account #:

List names, ages and relationship of all persons who will occupy the premises:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Personal References:

Name:

Phone:

Name:

Phone:

Name:

Phone:

In case of emergency, contact person:

Name:

Phone:

Name:

Phone:

Applicant's signature below denotes all the above information is accurate and authorizes Reily Realty & Management

to secure any credit information available on all information provided by applicant.

Signature:

Date:

Signature:

Date:

DRE #01407875