Pinnacle REM Application Draft

Building and Unit

Unit of Interest

Personal Information

Capitalize accordingly

Current Address

Current Living

Rental History

Previous Address 1

Previous Address 2

Personal References

Reference 1

Reference 2

Employment

Current Position

Emergency Contact

An individual not residing with you

Vehicle Information

Complete as possible

Payment + Certification

Applicant represents that the above information is true and correct, and hereby authorizes verification thereof. In consideration of the landlord processing, this application, I hereby tender the sum of $45.00. Of this sum, it is understood that $45.00 will be paid to the landlord as an administration charge for processing this application. Applicant acknowledges that a background check will be performed in this process - including but not limited to screening for criminal, rental and credit history.

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