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Address

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Rental Preferences

Preferred Move-in Date:

Monthly Budget Range:

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Number of Bedrooms:

Number of Bathrooms:

Desired Locations:

Are you looking for a pet-friendly unit?

Yes

No

Do you need a parking space?

Yes

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Household Details

Total Number of Occupants:

Do you or any occupant smoke?

Yes

No

Employment & Income

Current Employer Name:

Your Job Title:

Employment Start Date:

Monthly Income:

$

Rental History

Reason for Leaving:

Current Landlord Name:

Landlord Contact Number or Email:

Current Rent Amount:

$

Your Reason for Leaving:

How long have you lived there? (in months or years)

Reference

Reference Name

Relationship:

Phone Number or Email

I declare that the information provided is true and complete to the best of my knowledge. I authorize Rosen Realty to conduct background and credit checks as part of this application process.

I declare that the information provided is true and complete to the best of my knowledge. I authorize Rosen Realty to conduct background and credit checks as part of this application process.

Need help? Call us at (845) 316-1137 or message us through our Contact Page.

Guiding You Home with Trust,

Expertise, and Local Insight.

Licensed Real Estate Salesperson (NJ & NY)

(845) 316-1137

[email protected]

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