Rent 2 Own
El Shaddai Realty               
417 W. Vine Street
Kissimmee FL 34741           FL. Lic Real Estate Broker
 
Office: 321.284.1909
Cell:     321.948.1949
Fax:    321.248.0422
Email: Alex@rent2own.net
Alex_Photo.jpg (27267 bytes)
Alexander Barkhatkov
FL. Lic Real Estate /
Mortgage Broker
Home_Button.jpg (3379 bytes) About_Us_Button.jpg (4054 bytes) Our_Programs_Button.jpg (3312 bytes) Contact_Us_Button.jpg (3896 bytes)

Application_Button.jpg (4277 bytes)

Advertize_Button.jpg (4232 bytes)

Buy_Button2.jpg (2797 bytes)

Sell_Button2.jpg (2951 bytes)
Click Here to download the application or apply below (do NOT use this service below yet).
Rent_2_own_Button.jpg (4339 bytes)

Real_Estate_Button.jpg (4246 bytes)

Mortgage_Button.jpg (3971 bytes)

Management_Button.jpg (4464 bytes)

Marketing_Button.jpg (4026 bytes)

Investor_Button.jpg (3695 bytes)

Our_Services_Button.jpg (4437 bytes)

Our_Fees_Button.jpg (3761 bytes)

Rental Application

1. Personal Information

Name:
Home Number: *
Address:
City:
State: Zip:
E-mail:
# of Years:  Rent
Current Monthly Paymnets:
Landlord Name:
Landlord Number *

If less than 2 Years at Current Residence, please provide

Previous Address:
City:
State: Zip:
# of Years:  Rent   Own
Social Security # *
Landlord Name:
Landlord Number *
Marital Status Single   Married   Separated

2. Property Information

Check All That Apply Primary Residence
Second Home
Investment
Single Family Home
Condominium
Townhouse

3. Current Employment

Self Employed? (25% Ownership) Yes  No   % ownership
Employer Name:
Employer Address:
Employer Phone *  Start Date *
Position/Title:  #Yrs In this Profession
Yearly Base Salary $
Commission
(2yr Average) 		$
Bonus
(2yr Average) 		$

If less than 2 years with current please provide previous employer information below

Employer Name:
Employer Phone  *
Start Date: *  End Date: *
Yearly Income $   Position
Income From other Sources

4. Pet Information

Any Pets? Yes   No
If yes, are they insured? Yes   No
Pet Description #Dogs  #Cats  #Others
Name of the Insurance Carrier
Number of the Insurance Carrier * Acct#
Any Previous Pet Incidents/Accidents? Yes  No
If yes, use the following area to describe accident.

5. Liabilities (credit cards / car loans / student loans / mortgages / child support / alimony / other)

Name: Monthy Payment: Unpaid Balance:
Name: Monthy Payment: Unpaid Balance:
Name: Monthy Payment: Unpaid Balance:
Name: Monthy Payment: Unpaid Balance:
Name: Monthy Payment: Unpaid Balance:

6. Declarations

Are there any outstanding judgements against you?. Yes   No
Have you been declared bankrupt within the last 10 years? Yes   No
Have you been evicted? Yes   No
Are you currently delinquent on any financial obligations? Yes   No
Are you obligated to pay alimony, child support or separate maintenance? Yes   No
Is any part of the deposit borrowed? Yes   No
Did you co-sign on any loans from some one else? Yes   No
Are you a US Citizen? If not please fax Resident Alien card or Work Visa. Yes   No
Have you owned a home in the last 3 years? Yes   No
If so, how did you take title? Solely   With Spouse  With Other Person

7. References Information

1.
Name: Phone: *
Company: Fax: *
Relation: E-mail:
2.
Name: Phone:  *
Company: Fax:  *
Relation: E-mail:
3.
Name: Phone:  * 
Company: Fax:  * 
Relation: E-mail:
4.
Name: Phone:  * 
Company: Fax: *  
Relation: E-mail:
5.
Name: Phone:  * 
Company: Fax:  * 
Relation: E-mail:
6.
Name: Phone:  * 
Company: Fax:  * 
Relation: E-mail:
7.
Name: Phone:  * 
Company: Fax:  * 
Relation: E-mail:

8. Authorization and Certification

By checking below and typing in today's date, I authorize EL Shaddai Reality and/or Alexander Barkhatkov A FL Lic. Real Estate / Mortgage Broker to pull my credit and verify that all above provided information in association with this Rental application.

*Please use dashes and slashes for the dates and numbers please*

I agree Todays Date: *
    

      Hit Counter