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APPLICATION TO RENT

ALL SECTIONS MUST BE COMPLETE

INDIVIDUAL APPLICA TION REQUIRED FOR EACH APPLICANT

NAME:

SOCIAL SECURITY NUMBER

DATE OF BIRTH

CELL PHONE NUMBER

WORK NUMBER

1. CURRENTADDRESS

DATE IN

LANDLORD NAME

PHONE NUMBER

REASON FOR MOVING

2. FORMER ADDRESS

FORMER LANDLORD NAME

DATE OUT

RENT

DATE IN

PHONE NUMBER

DATE OUT

REASON FOR MOVING

RENT

PROPOSED OCCUPANTS:
LIST ALL IN ADDITION TO YOURSELF
NAME

AGE

EMPLOYMENT:
1. NAME OF CURRENT EMPLOYER

ADDRESS

PHONE NUMBER

NUMBER OF YEARS EMPLOYED

POSITION/ 111 LE

SUPERVISOR NAME & NUMBER


complete section 2 only if you have been at above employment for less than five years.

2 NAME OF CURRENT EMPLOYER

ADDRESS

PHONE NUMBER

NUMBER OF YEARS EMPLOYED

POSITION/ 111 LE

Current Gross Income

Week

Month

Year

BANK INFORMATION:
Name of Bank

Branch or address

Account Number(s)

Checking:
Savinas:
Other:

FINANCIAL OBLIGATIONS:
Name of Creditor

Address

Monthly Payment

Balance Due

EMERGENCY CONTACTS:
Name

Address

City, State, Zip

Phone

Relationship

City, State, Zip

Phone

Occupation

1.

2.

PERSONAL REFERENCES:
Name

Address

AUTOMOBILES, MOTORCYCLES OR OTHER VEHICLES:


Make

Model

Year

Color

License No.

Mother's Maiden Name: _______________________________________________________


Have you ever filed bankruptcy? ________Yes ________No If so, when:______________
Have you ever been evicted or asked to move?__________Yes___________No If so. why:

APPLICANT REPRESENTS THAT ALL THE ABOVE STATEMENTS ARE TRUE AND CORRECT AND HEREBY
AUTHORIZES VERIFICATION OF THE ABOVE ITEMS INCLUDING, BUT NOT LIMITED TO, OBTAINING A CREDIT
REPORT AND APPLICANT AGREES TO FURNISH ADDITIONAL CREDIT REFERENCES AND INFORMATION UPON
REQUEST.
The undersigned hereby makes application to rent the housing accommodations located at:
#9 Pembroke Road, Louisville, Kentucky 40220
The rent for the premises is $____________per month and upon approval of this application, applicant agrees to sign a
Lease Agreement and to pay all sums due, including required deposits before occupancy.

Lisa Hall {Signature)

Applicant {print name)

Date:

VEHICLES
#9 Pembroke Road
The Tenants are authorized to have the following vehicles on the property-.
Year

Make & Model

Color

License No.

Tenants shall keep only those vehicles and/or trailers listed above on the premises. Tenants agree to notify
and seek permission from Landlord to keep any additional vehicles not listed above on the premises.

Lisa Hall

Tenant

Date:

Date:

LEAD PAINT POISONING


Children get lead poisoning when they eat bits of paint that contain lead. Older
houses often have layers of lead paint on the walls, ceilings and woodwork. When the
paint chips off or when the plaster breaks, there is possible anger for babies and young
children. Outdoors, lead paints and primers may have been used in many places, such
as walls, fences and porches.
Be sure to tell your family and any guests with small children about the danger of
lead poisoning. A child can be poisoned by eating paint, dirt or other non-food
substances containing lead. Some other items which contain lead include newspaper,
pottery, furniture and even common household dust.
Since your home was probably built before 1978, it may have been painted with
lead based paint years ago. We wanted to warn you of the possible dangers. Realizing
this, and still wanting to rent this property from us, you hereby agree to hold Sugarbets
Rentals and the property owners and their agents, harmless from any problems which
could result from lead based paint, and any costs involved in diagnosis and treatment of
the same. This includes all who will be living with you for whom you are responsible and
all of your guests.
Date:
Lisa Hall

RENTAL AGREEMENT ADDENDUM


Address: #9 Pembroke Road. Louisville. Kentucky

Date:____

ANIMAL AGREEMENT
_______________________________________________have permission
have_____( ) dogs________( ) cats in the rental premises as described below:
Animal Type

Sex

Weight

to

Color

No animal of any kind, not provided for and described on this agreement, shall be
allowed without the full written consent of the Landlord. Tenants understand and
acknowledge that should there by a violation of any local ordinance or rental agreement
violation that can be attributed directly or indirectly to these animals, it shall result in an
removal of all animals involved from the property within five (5) days after receiving
written notice from the Landlord, City of Louisville or any other agency.
The Tenants further agree that both animals shall be kept in a kennel/crate when
t'ney are left on the premises alone or without adult supervision.
The Tenants further agree that the Landlord (Lessee) and owners shall not be
liable for any damage or losses to person or property caused by Tenant's animals.
Sugarbets Rentals:

Tenants:

by:______________________________
Rick L. Probus

_______
Lisa Hall

RENTAL AGREEMENT ADDENDUM


Address: #9 Pembroke Road, Louisville. Kentucky

Date:_____

ANIMAL AGREEMENT
_______________________________________________have permission
have_____( ) dogs________( ) cats in the rental premises as described below:
Animal Type

Sex

Weight

to

Color

No animal of any kind, not provided for and described on this agreement, shall be
allowed without the full written consent of the Landlord. Tenants understand and
acknowledge that should there by a violation of any local ordinance or rental agreement
violation that can be attributed directly or indirectly to these animals, it shall result in an
removal of all animals involved from the property within five (5) days after receiving
written notice from the Landlord, City of Louisville or any other agency.
The Tenants further agree that both animals shall be kept in a kennel/crate when
they are left on the premises alone or without adult supervision.
The Tenants further agree that the Landlord (Lessee) and owners shall not be
liable for any damage or losses to person or property caused by Tenant's animals.
Sugarbets Rentals:

Tenants:

by:______________________________
Rick L. Probus

_________________________________
Lisa Hall

LEAD PAINT POISONING


Children get lead poisoning when they eat bits of paint that contain lead. Older
houses often have layers of lead paint on the walls, ceilings and woodwork. When the
paint chips off or when the plaster breaks, there is possible anger for babies and young
children. Outdoors, lead paints and primers may have been used in many places, such
as walls, fences and porches.
Be sure to tell your family and any guests with small children about the danger of
lead poisoning. A child can be poisoned by eating paint, dirt or other non-food
substances containing lead. Some other items which contain lead include newspaper,
pottery, furniture and even common household dust.
Since your home was probably built before 1978, it may have been painted with
lead based paint years ago. We wanted to warn you of the possible dangers. Realizing
this, and still wanting to rent this property from us, you hereby agree to hold Sugarbets
Rentals and the property owners and their agents, harmless from any problems which
could result from lead based paint, and any costs involved in diagnosis and treatment of
the same. This includes all who will be living with you for whom you are responsible and
all of your guests.
Date:
___________________________
Lisa Hall

VEHICLES
#9 Pembroke Road
The Tenants are authorized to have the following vehicles on the property.
Year

Make & Model

Color

License No.

Tenants shall keep only those vehicles and/or trailers listed above on the premises. Tenants agree to notify
and seek permission from Landlord to keep any additional vehicles not listed above on the premises.

Lisa Mall

Tenant

Date:

Date:

APPLICATION TO RENT
ALL SECTIONS MUST BE COMPLETE

INDIVIDUAL APPLICA TION REQUIRED FOR EACH APPLICANT

NAME:

SOCIAL SECURITY NUMBER

DATE OF BIRTH

CELL PHONE NUMBER

WORK NUMBER

1. CURRENTADDRESS

LANDLORD NAME

DATE IN

PHONE NUMBER

REASON FOR MOVING

2. FORMER ADDRESS

FORMER LANDLORD NAME

DATE OUT

RENT

DATE IN

PHONE NUMBER

DATE OUT

REASON FOR MOVING

RENT

PROPOSED OCCUPANTS:
LIST ALL IN ADDITION TO YOURSELF

NAME

AGE

EMPLOYMENT:
1. NAME OF CURRENT EMPLOYER

ADDRESS

NUMBER OF YEARS EMPLOYED

PHONE NUMBER

POSITION/TITLE

SUPERVISOR NAME <& NUMBER

complete section 2 only if you have been at above employment for less than five years.

2 NAME OF CURRENT EMPLOYER

ADDRESS

PHONE NUMBER

NUMBER OF YEARS EMPLOYED

POSITION/TITLE

SUPERVISOR NAME & NUMBER

Current Gross Income

Week

Month

Year

BANK INFORMATION:
Name of Bank

Branch or Address

Account Number(s)

Checking:
Savings:

FINANCIAL OBLIGATIONS:
Name of Creditor

Address

Monthly Payment

Balance Due

EMERGENCY CONTACTS:
Name

Address

City, State, Zip

Phone

Relationship

City, State, Zip

Phone

Occupation

1.

2.

PERSONAL REFERENCES:
Name

Address

AUTOMOBILES, MOTORCYCLES OR OTHER VEHICLES:


Make

Model

Have you ever filed bankruptcy? __

Year

Color

Yes ___________________No If so, when:

Have you ever been evicted or asked to move?_Yes________No

If so, why:

License No.

APPLICANT REPRESENTS THAT ALL THE ABOVE STATEMENTS ARE TRUE AND CORRECT AND HEREBY
AUTHORIZES VERIFICATION OF THE ABOVE ITEMS INCLUDING, BUT NOT LIMITED TO, OBTAINING A CREDIT
REPORT AND APPLICANT AGREES TO FURNISH ADDITIONAL CREDIT REFERENCES AND INFORMATION UPON
REQUEST.

The undersigned hereby makes application to rent the housing accommodations located at:
#P Pembroke Road, Louisville, Kentucky 40220
The rent for the premises is $____________per month and upon approval of this application, applicant agrees to sign a
Lease Agreement and to pay all sums due, including required deposits before occupancy.

_______________________________________
Applicant Name (Print)

_______________________________________
Applicant Name (Print)

______________________________________ _
Applicant Signature
Date

_______________________________________
Applicant Signature
(Date)