RENTAL QUESTIONNAIRE Name(Required) First Last Email PhoneDate of birth(Required) MM slash DD slash YYYY Driver License # Additional Occupants Yes No Pets Yes No EMPLOYERCompany Name Company Address Company phone Your Title/Position BACKGROUNDHave you ever been evicted Yes No Ever filed for bankruptcy Yes No Ever been asked to leave for lease violations Yes No Ever been convicted of a crime Yes No Outstanding balances with landlords Yes No FINANCIAL STATEMENTMonthly Gross Income Car Note Yes No If yes how much Credit card debt Yes No If yes how much Credit card debt Yes No If yes how much Any Other debt Yes No If yes how much Any Other debt Yes No If yes how much AGREEMENT /CONSENTI, Mary Sahar hereby grant full permission to Gaylon Huddleston to verify the information provided in my rental application. This authorization includes, but is not limited to, contacting my current and previous landlords, employers, financial institutions, and personal references listed in my application. I understand that this verification process may involve the collection and exchange of personal information relevant to my rental application, and I consent to the use of such information for the sole purpose of assessing my suitability as a tenant. I acknowledge that any false or misleading information provided may result in the rejection of my application or termination of any lease or rental agreement entered into as a result of this application. Consent I agree to the above.