Prime Properties
3100 South Needles Highway, Suite 1000
Laughlin, Nevada  89029
*Ph: (702) 298-6000 * Fax: (702) 298-6002 * E-mail eraprime@eraprime.com
Website: http://www.eraprime.com

TENANT APPLICATION

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Applicant CO-APPLICANT/SPOUSE
Name: _______________________________
Social Security Number: _________________
Date of Birth: __________________________
Name: _______________________________
Social Security Number: _________________
Date of Birth: __________________________
Employment Employment
Occupation: ___________________________
Present Employer: ______________________
Phone: _______________________________
Supervisor: ____________________________
Salary (per month): _____________________
Date Hired: ___________________________
Occupation: ___________________________
Present Employer: ______________________
Phone: _______________________________
Supervisor: ____________________________
Salary (per month): _____________________
Date Hired: ___________________________
RESIDENCES RESIDENCES
Current Address:_________________________
_______________________________________
City/State/ZIP:___________________________
Landlord:_______________________________
Phone:_________________________________
Previous Address:________________________
_______________________________________
City/State/ZIP:___________________________
Landlord:_______________________________
Phone: _________________________________
Current Address:_________________________
_______________________________________
City/State/ZIP:___________________________
Landlord:_______________________________
Phone:_________________________________
Previous Address:________________________
_______________________________________
City/State/ZIP:___________________________
Landlord:_______________________________
Phone: _________________________________
Vehicle Vehicle
Year: ________________Make: ___________ 
Model: ______________ Color: ___________
License # :__________________ State:  ______
Diver's License #: ____________ State:_______
Year: ________________Make: ____________
Model: ______________ Color: ___________
License # :__________________ State:  ______
Diver's License #: ____________ State:_______
OTHER OCCUPANT INFORMATION:
Children (Names and Ages): ________________________________________________________
______________________________________________________________________________
Pets (Type and Name):____________________________________________________________
Have you ever been served an Eviction? _____ Details: _________________________________
CREDIT REFERENCES - APPLICANT CREDIT REFERENCES - CO-APPLICANT
Name: _______________________________
Phone: _______________________________
Name: _______________________________
Phone: _______________________________
Name: _______________________________
Phone: _______________________________
Name: _______________________________
Phone: _______________________________
In case of Emergency Notify:
Name: _________________________________
Relationship: ____________________________
Address: _______________________________
Phone: _________________________________

Authorization to Verify Information
I authorize Landlord or his agents  to verify the above information, including, but not limited to obtaining a credit report and; if this application is accepted, I agree to execute the residential lease or rental agreement. I also authorize any charges incurred while processing this application, $20.00 per Individual, or $25 per married couple. I also understand that if I cancel within 48 hours of approval, there will be a $50.00 cancellation charge; after 48 hours to move-in date, I forfeit the total deposit hereinafter acknowledged as received.
Date: __________________________________
Applicant: ______________________________
Telephone Number: _______________________
Co-Applicant: ___________________________
RECEIPT FOR DEPOSIT
The undersigned acknowledges receipt of $_______ in the form of (   ) cash, (   )cashier's check [Check #__________]  payable to Prime Properties as a deposit  on the above described property.
RECEIPT FOR Processing Fees
The undersigned acknowledges receipt of $_______ in the form of (   ) cash, (   )cashier's check [Check #__________]  payable to Prime Properties as a Processing Fee.
Date:________________________________
Agent: _________________________________