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Application To Be A Guest At Pau Hana Ranch


Date of requested occupancy:

One Person Only/ No Pets (Unless Otherwise Agreed In Writing)

The rent shall be payable in advance on the first day of each month of the tenancy. The first month’s rent plus a security deposit IN CASH shall be due upon signing the Guest Agreement and before moving in... Beginning with the second months rent personal checks will be accepted, unless a check is returned.

A CASH deposit of $ 200.00 is due with this application which will be applied toward and is an advance payment on the first months rent.
The Applicant understands that the Landlord will perform a credit check to verify all the information given on this application.
The cost of a credit report is $20 to be paid in cash by applicant. The cost of the report will be credited toward the first months rent if the application is approved.
If the credit report is negative or the credit score is below 675 the cost of the report will not be refunded.


Name ____________________________________________________________
Phone No.(____)_______________
Date of Birth: ______________
SSN: _______-______-_______
Driver's License No.: __________________
Vehicle Model: _____________________ Year: __________
License No.: ________________________

PRESENT ADDRESS: _______________________________________________
How long: __________________________
Landlord's Name: ___________________________________________________
Telephone No.: (____)____________
Current rent payment: _________
Reason for moving: _______________________________________________
Number of occupants: ___________

PRIOR ADDRESS: ___________________________________________________
How long: ___________
Landlord's Name: ____________________________________________________
Telephone No.: __________________________
Rent payment: _______________________
Reason for moving: ___________________________________________________
Number of occupants: ___________

Present Employer: __________________________________________________________
Address: ___________________________________________________________
Position: __________________________ How long: _______________
Supervisor: ________________________
Business Phone: (____)____________
Annual Income: _________________ Other income __________ Source ______________

If present employment is less than two years:
Prior Employer:
Position: How long:
Reason for Leaving:

I represent that the information provided in this Application is true and correct to the best of my knowledge.
I hereby authorize Pau Hana Ranch Company or its' agents to verify all information given in this Application.
Applicant understands that the landlord may terminate any rental agreement entered into for any misrepresentation made on this application.

Dated:


________________________________
Applicant's Signature