Rent-Buy Application

Preferred Store

Store *

Renter Information

Renters First Name *

Renters Last Name *

Cell Phone *

Email Address

Birth Date *

Street Address *

City *

State *

Zip *

Renter Employer/Income

Renters Employer/Source of Income *

Phone

Job Title

Take Home Pay

Monthly Take Home Pay Amount *

Residence Information

Rent or Own *

Time at this address

Landlord Name

Phone

Personal References

Optional. Add up to 4.

Reference 1 Name

Phone

Reference 2 Name

Phone

Reference 3 Name

Phone

Reference 4 Name

Phone

What Are You Interested In?

What are you interested in? (optional)

Legal & Consent

RELEASE OF INFORMATION TO Rent-Buy: (PLEASE READ BEFORE SIGNING)

The Information I(we) have provided on this form is correct. I(we) authorize confirmation of all information that I(we) have provided. Rent-Buy may contact any person or company that is listed above, and I(we) fully release all parties from all liability from any damage that may result.

FOR RENTER

I am applying for rental, am over 18 years of age, and I confirm the information above is accurate.

Informational SMS Consent (Optional): Rent Buy may text me about my request and account (replies to my questions, delivery and payment reminders). Msg & data rates may apply. Msg frequency varies. Reply STOP to opt out, HELP for help. For more info, read our Privacy Policy and Terms of Service.Promotional SMS Consent (Optional): Rent Buy may text me deals and promotions. Optional. Msg frequency varies. Consent is not a condition of renting or buying. Msg & data rates may apply. Reply STOP to opt out.