Richard Properties Commercial Rental Application APPLICANT INFORMATION First Name: MI: Last Name: Home Address: City: State: Zip: Home Phone: Mobile Number: E-mail Address: Social Security Number: Driver’s License Number: How long have you lived at your current address? OwnRent If renting, name of landlord: Landlord Phone: PROFESSIONAL INFORMATION Name of business: Requested Move-in Date: Requested Length of Lease: Type of Business/Service: Current Business Address: Current Landlord: Landlord Phone number: Length of Time at this Address: Reason for Leaving: EMERGENCY CONTACT INFORMATION First Name: Last Name: Relationship: Home Phone: Work Phone: Mobile: SIGNATURE & DISCLAIMNER I certify that my answers are correct to the best of my knowledge. It is fully understood that this application is not intended to create a contract unless a lease agreement is fully executed by both parties. This application does hereby authorize Richard Properties to conduct a full credit and background search and report. Your Signature: Date: The above information will be used to determine renal eligibility. Information gathered is strictly confidential. All qualified applicants over 18 years of age are considered regardless of race, creed, color, sex, religion, national origin, age, disability and any other reason protected by law.