NATIONAL TENANT NETWORK RENTAL APPLICATION FORM
SUBSCRIBER ACCOUNT NUMBER PH4250:   1-800-885-7528
MAKE $25.00 CHECK PAYABLE TO THOMAS GILLES. MAIL APPLICATION ALONG WITH 
PHOTO COPY OF DRIVERS LICENSE TO: PO BOX 371 PERKASIE, PA 18944

APARTMENT OR HOUSE APPLIED FOR:_____________________________________
FIRST NAME:_______________            
LAST:___________________         
M.I.:_______
DATE OF BIRTH:____/____/____          
SOCIAL SECURITY #:____ - ___ - ______
HOME PHONE#:(___) - ____ - _____    
CELL#:(___) - ____ - _____ 
WORK#:(___) - ____ - _____
CURRENT ADDRESS:________________________________
                ________________________________

PREVIOUS ADDRESS:________________________________
                 ________________________________
REASON FOR MOVING FROM PRESENT ADDRESS:____________________________________
PRESENT LANDLORDS NAME AND PHONE#:_________________ 
(___) - ____ - _____ 
PRESENT LANDLORDS MAILING ADDRESS:____________________________
PRESENT MONTHLY RENTAL AMOUNT: $_ญญ_____.___                
SECURITY:___________
PRESENT EMPLOYERS NAME AND ADDRESS:_____________________
                                   _____________________
EMPLOYED FROM WHAT DATE:____/____/______  
POSITION:____________________
EMPLOYERS PHONE NUMBER:(___) - ____ - _____ 
CURRENT MONTHLY TAKE HOME PAY: $_______.___            
HOURLY RATE: $_____.___  
DO YOU HAVE A BANK ACCOUNT(?):________     
CHECKING:______       
SAVINGS:______
APPLICANTS SIGNATURE: X______________________________________
PERFORM COMBINED CREDIT/NTN TENANT PERFORMANCE REPORT:


         
FINANCIAL QUALIFIER OF APPLICANT

DEBT PER MONTH

CAR PAYMENT: $_______.___
CAR INSURANCE: $_______.___
INSPECTION/EMISSION TESTS: $_______.___
FLUIDS/FILTERS/BRAKES/BATTERY/TIRES/REPAIRS: $_______.___
GAS FOR VEHICLE: $_______.___
UTILITIES - ELECTRIC/HEAT: $_______.___
UTILITIES - WATER/SEWER: $_______.___
PHONE&CELL PHONE BILL: $_______.___
CABLE/DISH TV INTERNET SERVICE: $_______.___
TRASH/OTHER FEES: $_______.___
GROCERY/HYGIENE: $______.___                         
ONCE PLUS $100 PER MINOR DEPENDANT
TOBACCO (IF APPLICABLE): $_______.___
ALCOHOL/MEDICATION: $_______.___
PET (IF APPLICABLE): $_______.___
MISCELLANEOUS: $_______.___
CREDIT CARD: $_______.___
PERSONAL LOAN: $_______.___
STUDENT LOANS: $_______.___
HEALTH INSURANCE: $_______.___
SUPPORT/ALIMONY; $_______.___
FINES/JUDGEMENTS/LIENS
DOCTORS/LAWYER/CPA BILLS: $_______.___

MONTHLY INCOME

PRIMARY JOB(NET TAKE HOME PAY): $_______.___
SECOND JOB(NET TAKE HOME PAY): $_______.___
SUPPORT: $_______.___
ALIMONY: $_______.___
SOCIAL SECURITY Benefits:________  
WHAT TYPE: SSD  |  SSI   
SURVIVORS Benefit:_____________
INSURANCE Benefit:____________
OTHER:_____________________