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Real Estate Is Opportunity and we help you in realizing it

MAYUR DEMBLA

408-228-7411
MayurDembla@gmail.com

SHRESHTH DEMBLA

925-325-7265
ShreshthDembla@gmail.com

Rental Application

Please complete each required field marked with *

Selected Home

Property Address~

Test, street-123, New York City, New york, 12, New York, NY 10005

Home Information

5 bed, 4 bath, 6,000 sf, Family

Applicant Information

Full Name*

DOB* (mm/dd/yyyy)

SSN*

Driver License #*

Driver License State*

DL Expiry Date* (mm/dd/yyyy)

Phone*

Email*

Dependents (Name, DOB)

Smoking (including vaping, e-cigarettes)*

Yes

Do you have pets?*

Yes

Employment

Employment Status*

Full Time

Part Time

Student

Unemployed

Employer

How Long?

Position

Start Date (mm/dd/yyyy)

Salary

Salary Frequency

Weekly

Bi-Weekly

Monthly

Yearly

Supervisor Name

Supervisor Phone

Previous Employer or School

Any Other Source of Income

Source

Residential History

Current Address*

City*

State*

Zip*

Month/Year Moved In* (mm/dd/yyyy)

Lived For*

2 years or more

Less than 2 years

Own/Rent*

Own

Rent

Rent / Monthly Payment*

Owner / Agent*

Owner / Agent Phone Number*

Previous Address

Address

City

State

Zip

Month/Year Moved In (mm/dd/yyyy)

Rent / Monthly Payment

Reasons for Leaving

Owner / Agent

Owner / Agent Phone Number

Credit History

Declared bankruptcy in the past seven (7) years?*

Yes

Ever been evicted from a rental residence?*

Yes

Had two or more late rental payments in the past year?*

Yes

Ever willfully or intentionally refused to pay rent when due?*

Yes

Emergency Contact

Name

Relationship

Phone

Vehicle Information

Year

Make

Model

Color

License Plate

Application Processing Fee

Amount

$40.00

Payment

Zelle

Per applicant 18+, non-refundable.

Zelle To: SeasonedPropertyManagement@gmail.com

Acknowledgement / Authorization

I authorize investigation of the information submitted in this application for rental review purposes.

Name*

Date* (mm/dd/yyyy)

08/08/2026

Additional Information

(~) The application is valid for all properties represented by Seasoned Property Management.