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Applicant(s): List all occupants and ages, including children:
Applicant 1
First Name:
Middle Name:
Last Name:
Social Security #:
Date of Birth:

Applicant 2
First Name:
Middle Name:
Last Name:
Social Security #:
Date of Birth:

Applicant 3
First Name:
Middle Name:
Last Name:
Social Security #:
Date of Birth:


Current Street Address:
Address:
City, State, Zip:
Phone:
Email:


Current (or most recent) Landlord Information:
Landlord's Name:
 
Landlord's Address:
Rented how long?
  
From:
To:
      


Employment Information:
Employer's Name:
  
Address:
City, State, Zip:
Phone:
Supervisor Name:
Your Position:
Salary:
Length of Employment:
Military:
No Yes
Rank:
Squadron:


Other Income:
Source:
Amount $:
Source:
Amount $:


Vehicles:
Make:
Color:
License #:
Make:
Color:
License #:


References:
Personal:
Phone:
Personal:
Phone:
Personal:
Phone:


Financial Information:
Bank:
Checking:
Savings:
    


May we contact the above refrences?
Yes
No
  


Have you rented from Barker & Little before?
Yes
No
  
If yes, when?
      


Do you have any pets?
Yes
No
  
If yes, what kind?
      


Have you ever been convicted of a felony?
Yes
No
  
If yes, please explain?
    


Applicant(s) hereby agree(s), consent(s), and give(s) permission to Barker & Little, Inc or it's agents and employees, to contact references and/or other agencies to complete a background records search related to this lease application.  This application is hereby incorporated into any future lease between the applicant and Barker & Little, Inc.

Privacy Policy:  Barker & Little, Inc will only use your private information to determine your eligibility to lease from us.  Barker & Little, Inc will provide any personal information to third parties other than to complete a record check as provided by law..

All security deposits will be forfeited after the first 24 hours unless the application is denied.


   
I agree to these terms
  


   
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Barker & Little, 816 St Joseph Rapid City SD 57701
phone:605-923-4785, toll free:800-894-1140, email-