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C&E Wurzer Rental Application

Fill out this form to apply for a rental property

First Name*

Middle Name*

Last Name*

Birth Date*

Social Security # & Driver's License #

This information may be requested as needed

Other Names You've Used

Home Phone

Cell Phone*

Consent to text

By checking this box and submitting this form, you consent to receive SMS text messages from C&E Wurzer Builders about reminders, scheduling, promotions, and updates. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out of further messaging and HELP for assistance or call (715) 839-8806. Our Privacy Policy and Terms can be viewed here.

All Other Proposed Occupants*

Please enter all other proposed occupants, including name, birth date & relationship to applicant

Rental/Residence History

Please enter information in this section about your rental history

Current Residence:*

Please enter the following information about your current residence:
- Address
- Last rent amount paid
- Owner/Manager name & phone

Is/was rent paid in full?*

Yes

Did you give notice?*

Yes

Were you asked to move?*

Yes

Name(s) in which your utilities are now billed:*

Date of Residency - From/To:*

Previous Residence

Please enter information about your previous residence:

Previous Residence:

Please enter the following information about your previous residence:
- Address
- Last rent amount paid
- Owner/Manager name & phone

Was rent paid in full?

Yes

Did you give notice?

Yes

Were you asked to move?

Yes

Date of Residency - From/To:

Employment History

Please enter information about your employment history:

Employed by:*

Employer Address:*

Employer's Phone Number:

Occupation:

Name of Supervisor:

Monthly Gross Pay:

Dates of Employment - From/To:

Previous Employer

Please enter information about your previous employement:

Previously Employed By:

Previous Employer Address:

Previous Employer's Phone Number:

Previous Occupation:

Previous Name of Supervisor:

Previous Monthly Gross Pay:

Dates of Employment - From/To:

Credit History

Please enter information about your credit history:

Savings Account - Bank Name & Balance on Deposit or Balance Owed

Checking Account - Bank Name & Balance on Deposit or Balance Owed

Credit Card - Bank Name & Balance on Deposit or Balance Owed

Auto Loan - Bank Name & Balance on Deposit or Balance Owed

Vehicle(s) Information - Make, Model, Color, Year & License Plate #*

Please enter Make, Model, Color, Year & License Plate #

References & Emergency Contact

Please enter the Name, Address & Phone number of your Emergency Contact(s), such as Doctor, Lawyer, or Nearest Relative Living Elsewhere:

Emergency Contact*

Please enter Name, Address & Phone Number of your emergency contact(s)

*By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you. Furthermore, if you abandon the apartment for any reason then you grant us permission to allow your relative listed above to remove all contents of the dwelling on your behalf.

General Information:

Have you ever been served a late rent notice?*

Yes

Do any of the people who would be living in the apartment smoke?*

Yes

How long do you think you would be renting from us?*

Have you ever filed for bankruptcy? If so, when?*

When would you be able to move in?*

Have you ever been convicted of a felony?*

Have you ever been served an eviction notice? If so, when?*

How many pets do you have (list Type, Breed, approx Weight & Age)?*

Have you had any reoccurring problems with your current apartment or landlord? If yes, please explain:*

Why are you moving from your current address?*

List any verifiable sources and amounts of income you wish to have considered (optional):*

If you were to run into financial difficulty in the future and couldn’t come up with the money to pay the rent, do you know someone that would loan you the money? If so, provide the person’s name, address, & phone # so that we can use them as a reference for you.*

Have you been a party to a lawsuit in the past? If yes, please explain why:*

We may run a credit check and a criminal background check. Is there anything negative we will find that you want to comment on?*

How did you hear about this apartment?*

Do you have an e-mail address we can reach you at?*

Do you know of anybody else looking for an apartment? Please provide their name and number. If you refer a friend and you each end up renting separate apartments from us then we will pay you a referral reward.

Agreement & Authorization Signature

I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification of information I provided and communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for an apartment and does not constitute a rental or lease agreement in whole or part. I further understand that there is a non-refundable fee to cover the cost of processing my application and I am not entitled to a refund even if I don’t get the apartment. Any questions regarding rejected applications must be submitted in writing and accompanied by a self-addressed stamped envelope.

Signature:*

Date*

SPRING SAVINGS NOW UNTIL APRIL 30th!

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Rental Application