Stropes Real Estate   334 Saint Mary Street, Pekin Illionois 61554
Rental Application     Print form & fill it out.  Drop off, fax or mail to office.
Personal Information            
   
Apartment Type Wanted:     Estimated Rent:    
   
Desired Move-In Date:     Pets:      
   
Name:       Social Security #:    
   
Spouse Name:     Social Security #:    
   
Birth Date:       Spouse Birth date:    
   
Number of people who will occupy:  Adults (over 18)        
   
Children and Ages:              
   
In case of emergency, notify:            
            NAME                   ADDRESS   PHONE  
Residence History              
   
Present Address:     Present Phone:    
   
Present Landlord:     Phone:   From:            To:  
   
Amount of Rent:   Reason for Leaving:        
   
Previous Address:         From:            To:  
   
Amount of Rent:   Reason for Leaving:        
                 
Employment References            
   
Employed By:     Phone:     From:  
   
Address:       Position:     Mo. Income:  
   
Spouse Employed By:     Phone:     From:  
   
Address:       Position:     Mo. Income:  
   
                 
Credit and Character References          
   
Name of Firm:     Address:     Phone:  
                 
   
                 
                 
Special Information            
                 
Been evicted from tenancy?   Filed for bankruptcy?:    
   
Drivers License #:     Spouse's Driver License #:  
   
   
Vehicle Make & Year:     License:      
   
Vehicle Make & Year:     License:      
   
The undersigned hereby acknowledges that the above information is true and expressly authorizes
   
Stropes Real Estate and/or its agents to verify said information, by, but not limited to, checking
references, credit reports and criminal background.
Applicant     Date Applicant     Date