Rental Application
Mail to or drop off at:

D3VON, LLC
7 S. Washington St.
Binghamton NY 13903

Phone: (607) 651-6833
Fax to: (607) 722-6650

Separate application required from each adult applicant (age 18 or older). If approved, all adults living at the rental must sign the lease.
Address of Property to Be Rented: ________________________ Term: from ________ to ________

Applicant Full Name (print clearly!!): ______________________ Phone: (____)_____________
Additional Occupants Full Names, relationship to Applicant: ___________________________
_______________________________________________________________________________

Rental History
CURRENT Address: ________________ Term: _____________________
City, State, ZIP:_____________________ Reason for Leaving: ______________
Landlord/Manager: __________________ Landlord's Phone: (____)__________
Previous Address Street Address: _____________________ Term: ____________________
City, State, ZIP:_____________________ Reason for Leaving: ______________
Landlord/Manager: __________________ Landlord's Phone: (____)__________

Employment History
Current Employer Name, Address (street, city, state): ___________________________________
Name of Supervisor: ____________________
Dates Employed at This Job: ____________________ Position or Title: ___________________
------------------------
Previous Employer Name, Address (street, city, state): __________________________________
Name of Supervisor: ____________________
Dates Employed at This Job: ____________________ Position or Title: ___________________

Income & Obligations
1. Your gross monthly employment income (before deductions): $ ________
2. Average monthly amounts of other income (specify sources): $ ________
Major Obligation(s): Creditor __________________ Amount Owed ______ Monthly Payment _______
Creditor __________________ Amount Owed ______ Monthly Payment _______
Miscellaneous
Describe the number and type of pets you want to have in the rental property: ____________________________________________
Describe water-filled furniture you want to have in the rental property: __________________________________________________
Do you smoke? [ ] yes [ ] no
Have you ever:
Filed for bankruptcy? [ ] yes [ ] no
Been sued? [ ] yes [ ] no
Been evicted? [ ] yes [ ] no
Been convicted of a crime? [ ] yes [ ] no

Explain any yes listed above: ________________________________________________________________________________
I certify that all the information given above is true and correct and understand that my lease or rental agreement may be terminated if I have made any false or incomplete statement in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers and personal references.

Date _______________ Applicant signature __________________________________
(authorization to check references)

Consent to Contact References and Perform Credit Check
I authorize Devon McBride (the landlord) to obtain information about me from my credit sources, current and previous landlords, employers, and personal references to enable him to evaluate my rental application. I give permission for the landlord or its agent to obtain a consumer report about me for the purpose of this application, to ensure that I continue to meet the terms of the tenancy, for the collection and recovery of any financial obligations relating to my tenancy, or for any other permissible purpose.

(The Consumer Credit Report is obtained from Experian at a cost of $9.95, paid by each applicant. Make check payable to D3VON, LLC, or fill out credit card authorization form and submit with application.)

_______________________________ _________________
Applicant signature (authorization to check credit) Date
_______________________________
Social Security Number

_________________________________
Billing address (if different from current address)