Rental Application
Rental Application
G. E. Matthews, Inc.
Property Management
207 Temple Ave
Colonial Heights VA 23834
(804) 518-0510
(804- 518-0505 Fax
Notice: Co-Applicant must complete a separate Rental Application Form. Application is only good for 30 days.
Property address applying for: ________________________________________________________
Monthly rental amount $___________________ How did you hear about us? _________________________
Are you currently in the military services? Yes No
PLEASE TELL US ABOUT YOURSELF
LAST NAME_________________ FIRST: ______________________________ MIDDLE INITIAL:_____ PHONE ( ) ______________
DATE OF BIRTH: ____________________________ SOCIAL SECURITY NUMBER _____________________________
SPOUSES FULL NAME ________________________ SOCIAL SECURITY NUMBER _____________________________
Others Persons to occupy residence (Use separate sheet if more room is needed): Anyone over 18 must provide an ID.
NAME ___________________________ RELATIONSHIP______________________ AGE _________________________
NAME ___________________________ RELATIONSHIP______________________ AGE__________________________
NAME ___________________________ RELATIONSHIP _____________________ AGE __________________________
NAME ___________________________ RELATIONSHIP _____________________ AGE __________________________
PETS (MUMBER AND KIND) ____________________________________________________________________________
PLEASE GIVE US YOUR RESIDENCE HISTORY
CURRENT ADDRESS ________________________________________________________________________________
LENGTH OF TIME AT ADDRESS _____________________________________________ MONTHLY RENT _____________________
OWNER/AGENT/LANDLORD ________________________________________________ PHONE _____________________________
PREVIOUS ADDRESS ______________________________________________________________
LENGTH OF TIME AT ADDRESS _____________________________________________ MONTHLY RENT __________________
OWNER/AGENT/LANDLORD _________________________________________________ PHONE _________________________
REASON FOR LEAVING ________________________________________________________________
PLEASE GIVE US YOUR EMPLOYMENT HISTORY
YOUR STATUS ____ EMPLOYED FULL TIME ___ EMPLOYED PART TIME ___ STUDENT ___ RETIRED ____ UNEMPLOYED
CURRENT EMPLOYER _________________________________________ HOW LONG? _____________________________
EMPLOYER ADDRESS _________________________________________ TELEPHONE _______________________________
SUPERVISOR ______________________ POSITION HELD ______________________ SALARY $_____________ PER MONTH
If there are other sources of income you would like to consider. please list income, source, and a pay stub for confirmation. You do NOT have to reveal alimony, child support, or other, unless you want us to consider it in this application.
AMOUNT $__________________________ SOURCE ____________________________________
AMOUNT $__________________________ SOURCE ____________________________________
PLEASE LIST YOUR BANK AND CREDIT REFERENCES
YOUR BANK (S) CITY/STATE TYPE OF ACCOUNT ACCOUNT NUMBER
1)____________________________________________________________________________________________________________
2)____________________________________________________________________________________________________________
CREDIT REFERENCES CITY/STATE ACCOUNT NUMBER
1)____________________________________________________________________________________________________________
2)____________________________________________________________________________________________________________
THIS APPLICATION WILL BECOME PART OF YOUR LEASE
PLEASE INCLUDE THE FOLLOWING WHEN SUBMITTING AN APPLICATION:
SOCIAL SECURITY CARD, PROOF OF INCOME, STATE ISSUED ID, $32 APPLICATION FEE
SECURITY DEPOSITS MUST BE IN THE FORM OF MONEY ORDERS ONLY
PERSONAL REFERENCES (NOT INCLUDING RELATIVES)
NAME ADDRESS YEARS KNOWN TELEPHONE NUMBER
1)____________________________________________________________________________________________________________
2)____________________________________________________________________________________________________________
DRIVERS LICENSE NUMBER _____________________________
YOUR VEHICLE MAKE/MODEL _______________________ YEAR ______________________ TAG NUMBER ____________________
YOUR VEHICLE MAKE/MODEL _______________________ YEAR ______________________ TAG NUMBER ____________________
OTHER VEHICLES _______________________________________________________________________________________________
HAVE YOU EVER:
Filed for Bankruptcy? _________Yes ________No
Been evicted from tenancy? _________ Yes ________No
Willfully or intentially refused to pay rent when due? _______Yes ________No
Been convicted of a felony? _______ Yes _________No
Had judgment/collections place against you _________Yes ________No
Please give any additional information you might help management evaluate this application.
_______________________________________________________________________________________________________________
________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
I hereby apply to lease the above listed described premises for the term and upon the conditions above set forth and agree that the rental is to be payable the FIRST day of each month in advance. As and inducement to the owner of the property and to agent to accept this application. I warrant that all statements above set forth are true; however should any statement made above be a misrepresentation or not a true statement of facts, this application will be null and void.
I hereby deposit an application fee in the amount of $32.00 per application which is non-refundable whether this application is approved or not approved. By signing below, I hereby give authorization to G. E. Matthews, Inc. to obtain a Credit Report from the Retail Merchants Association, as well as to verify any and all references listed on my application or other references regarding my person. Please provide proof of income, state issued identification and social security card when submitting an application.
Obligation to enter into Lease Agreement/Damages: Upon submission of this application by applicant, Agent reserves the right to remove the Dwelling Unit from the available rent list. If this applicant fails to rent the dwelling unit, Landlord shall be entitled to retain that part of the application deposit equal to Landlord's actual damages and expenses as otherwise provided in the Virginia Residential landlord Tenant Act ("VRLTA").
I hereby acknowledge the disclosure that G.E. Matthews and its agents represents the landlord in this real estate transaction. I recognize that as part of your procedure for processing my application, an investigative consumer report and criminal check may be prepared whereby information is obtained through personal interviews with my neighbors, friends, and others with whom I may be acquainted, this inquiry includes information as to my character, general reputation, personal characteristics,and mode of living.
I understand and authorize all dishonored check plus a processing fee with applicable taxes to be electronically debted from my account:
The above information, to the best of my knowledge, is true and correct.
Signature of Applicant________________________________________________ Date_____________________________
I understand and authorize all dishonored checks plus a processing fee with applicable taxes to be electronically debited from my account. As you may or may not know, Property built before 1978 may contain lead based paint. If built prior to 1978, please consider it to contain Lead Base Paint. If applicable, agent has given all documentation known by Agent concerning lead base paint, provided by Owner/Landlord. Tenant has received Lead Booklet/Lead Addendum/Renovation Booklet. In addition WE suggest you take precautions you deem necessary. Properties may or may contain Radon, Mold, Carbon Monoxide, or other gas unknown to the Landlord or Agent. If tenant is aware, Tenant shall advise Landlord/Agent of such condition. Tenants, Parents, Guardians, here by agree to take all reasonable precautions to prevent children or themselves from being exposed to Paint and other substances containing Lead or other harmful substances or conditions. Precautions shall include but not limited to: (a) Sweeping up paint chips and plaster. (b) Close supervision to prevent children form ingesting Lead. (c) Educating older siblings and babysitters about Lead Hazards and their danger to children. We suggest you use water filtration for drinking water, due to possible chlorine. We suggest precautions for chemicals or other contaminates and conditions that may be found. Tenant shall indemnify and hold Agent/Owner harmless and will reimburse Agent/Owner for any loss, liability, claim, damage, expense (including costs of investigation, defense, and reasonable attorneys fees and expenses) arising from or in connection with any such claims. Tenants are responsible for all rents not paid by the Housing Assistance Program. All pets are to be pre-approved by the Agent/Owner. The following breeds are deemed dangerous and therefore prohibited: Pitt Bulls, Rottweiler’s, Chow Chow, Doberman Pinchers, German Shepards, Siberian Huskies, Alaskan Malamutes, Akitas, American Staffordshire Terriers, Boxers, Great Danes, Wolf-Hybrids, Perro de Presa Canarios. Tenant is hereby advised that Mold and or other Organisms may exist at the property. Tenant agrees to take steps to prevent mold in the household to include but not limited to: 1. Preventing splashing of water out of the tubs or sinks. 2. Advise Landlord/Agent of any Roof or Plumbing Leaks and Clean up any water caused by such. 3. No uses of supplemental heat may cause moisture to form on the walls. 4. Clean house and appliances on a regular basis. 5. Advise all occupants of mold prevention. Tenant acknowledges and agrees to accept full responsibility/risk for any matters that may result from Microscopic organisms and or Mold. There are to be NO Kerosene Heaters or Space Heaters to be used at the Rental Unit. DO NOT remove smoke detectors for any reason. Tenant is responsible for checking and changing the batteries as needed. Outlets in the unit may or may not be grounded. Tenant shall indemnify and hold Agent/Owner harmless and will reimburse Agent/Owner for any loss, liability, claim, damage, expense (including costs of investigation, defense, and reasonable attorneys fees and expenses) arising from or in connection with any such claims mentioned in the paragraph above.
***For All Commercial Leases---Businesses that want to change type of business from original intent when lease began, explicit permission must be given by the Landlord/Agent. ** Agent represents Landlord. *** Per City Code Compliance at no time shall a tenant pour household grease on the exterior of the home. Proper disposal is required at all times. *** Per City Code Compliance at no time shall a tenant dump hot charcoal briquettes on the exterior of the home. This is a fire safety hazard.
*** EQUAL HOUSING OPPORTUNITY.
