APPLICATION FOR TENANCY

J & L RICHARD PROPERTIES LLC, JL REAL ESTATE HOLDINGS LLC

Each Adult Must: Provide Photo ID; Complete APPLICATION, Read Our Rules. We collect as many Applications as possible. We check references for Applicants. We do not rent to anyone whose references we can't contact. We do not allow anyone to move in immediately. We require 1 personal non-relative reference knowing you 3 years. We do not rent to the 1st Applicant; We rent to BEST APPLICANT meeting requirements. We make decisions based on Personal History, not Personal Appearance. We may require Co-Signer.

NAMES AND RELATIONSHIPS OF EVERYONE WHO WILL OCCUPY UNIT including ages of minors:

Provided Landlord 30-Days' Written Notice? YesNo

IMPORTANT! INCLUDE 3 YRS LANDLORD/EMPLOYMENT/INCOME REFERENCES! Use back side if needed.

SHIFT: DayNightSupervisor

Subject to transfer? YesNo

Checking Account?

Savings Account?

RENT PAYMENTS EVER BEEN LATE?

EVER BEEN EVICTED?

If yes, explain on back.

ABLE TO MEET REQUIREMENTS OF TENANCY THAT APPLY TO ALL TENANTS?

May make extra comments on back side.

NEED INTERPRETER?

PLAN IN-RESIDENCE BUSINESS ACTIVITIES?

CAN OBTAIN A CO-SIGNER?

HAVE/EXPECT TO HAVE PETS?

UTILITIES PRESENTLY/RECENTLY IN YOUR NAME?

EQUIPMENT PRESENTLY OWNED?

DO YOU READ ENGLISH?

I authorize Landlord to check information for verification by all available means: consumer reporting agencies, public records, current/previous rental property owners/employers/personal references. Reverification or investigation of preliminary findings is not required. If any of my answers are found to be incorrect, any Rental Agreement becomes void & will be sufficient reason for eviction & loss of Security Deposit. I also authorize verification of Employment, Military status, Bank accounts, Credit History [including Credit Bureau Report], Criminal Records, Rental history, Income, Evictions/Judgments, Student status. I declare that my Rental history & Credit records are in good standing & understand that if I am accepted & fail to complete this transaction by promptly signing any required papers, any deposit will be forfeited.

APPLICANT'S SIGNATURE


APPLICATION FOR TENANCY - Page 2

QUAD CITIES RENTAL PROPERTY ASSOCIATION, INC.

Please answer the following as they apply to you, to current household members, or anyone who will be living with you. [Use another sheet if necessary.]

1. Ever convicted on a charge involving illegal use, abuse, possession, manufacture or distribution of a controlled substance OR plead "No Contest" to any drug and/or alcohol charges?

You

If yes for anyone, please indicate:

2. A current legal or illegal user of a controlled substance?

You

If yes for anyone, please indicate:

3. Ever convicted of a felony or aggravated misdemeanor?

You

If yes for anyone, please indicate:

4. Have you or any household member ever been:
Charged/convicted/pleaded "No contest" to any sex offender charge?
Registered or required to be registered as a sex offender?
On any state's sex offender list?

You

If yes for anyone, please indicate:

5. Ever been a DEFENDANT in a Forcible Entry and Detention FE&D [eviction] action?

You

If yes for anyone, please indicate:

6. Ever been a DEFENDANT in Money Judgment action for:

Unpaid rent/utilities?
Damages?
Noncompliance?

You

If yes for anyone, please indicate:

7. Any adverse credit conditions/situations in recent history that will show up on your credit report?

You

If yes for anyone, please indicate:

APPLICANT SIGNATURE