Should you be interested in renting an apartment from us, we will need you to complete an application to rent.
Please print an application, or fill it out below. Your responses are e-mailed directly to us. Thank you.
* Required

For Which Rental Address?
   
Full Name
*
E-mail
*
Home Phone
Cell Phone
Date of Birth
Status Married Single Divorced
   
Present Address
City
State Zip/Postal Code
How long?
Rent
Reason Leaving?
Owner/Manager
Phone
   
Previous Address
City
State Zip/Postal Code
How long?
Rent
Reason Leaving?
Owner/Manager
Phone
   
Does anyone smoke? Yes No
Proposed Move In Date
Name & relationship of every person to live with you, even if only temporarily (including age of minors):
Any Pets? Yes No
  If YES, describe:
Waterbed? Yes No
   
Present Occupation
Employer
Phone
How long?
Supervisor
Phone
   
Previous Occupation
Employer
Phone
How long?
Supervisor
Phone
   
Current Gross Income $ per month before deductions
List sources & amounts
of other income:
Alimony/Child Support? Receive $ or Pay $
   
Credit References  
Company
Phone
Company
Phone
   
Have you ever filed for bankruptcy? Yes No
Have you ever been evicted? Yes No
Have you ever been convicted of a felony? Yes No
   
Vehicle Make(s)
Model(s)
Year(s)
Lincense(s)
   
Personal References  
Name
Address
Phone
   
Name
Address
Phone
   
Emergency Contact  
Name
Address
Phone
   
Comments /
Questions
   
  I declare that the statements above are true and corret. I authorize verification of my credit and references as they relate to my tenancy and to future rent collection.
   
  Please enter these numbers to complete this request.
   
 
>> DOWNLOAD RENTAL APPLICATION (PDF) <<

Address:
106 West Street, Suite 3
Rutland, VT 05701

Fax: 802-747-3559 / 802-265-9004

E-mail: nelsonrentalsvt@gmail.com