COLVIN’S DUPLEX RENTALS, L.L.C.
P.O. Box 271 RUSTON, LA. 71273-0271
318-255-0245 Fax 318-254-1198

Please fill out this form, print it and fax to: 318-254-1198. This form cannot be submitted via the Internet.

 LEASE APPLICATION

Name:                          

Social Security #:          

Birthdate:                    

Drivers License #:         

    (mail or fax copy of license with application)

Occupation:                  
(If Student, est. graduation date: 

Place of Employment:    

Employer's Name:          

Employment Phone #:    

Current Landlord:          

Landlord Phone #:         

Current Address:           

City:                              State:

Zip:                             

Current Phone #:           

Cell Phone#:                 

Email:                          

Parents Name:              

Parents Address:             City, State & Zip:            

Parents Phone #:          

Reason for leaving current address:

                

Names of People includes as Tenants: (Limit 2 people)

Preferred move-in date:

List Current Income Amount, Supervisor and Phone # for Verification:

  I  understand that by submitting a rental or deposit payment for an apartment, that I have committed to a one year agreement, subject to application verification, credit/background check, and approval, and  I will lose my rental or deposit payment if I change my mind.  Rental or deposit monies will be refunded if the application is not approved.  I understand that the lease is available online to read and approve before I make this commitment.  I give my permission for a credit/background check and employment/income verification for the purpose of this rental.

(SIGNATURE REQUIRED-may be evidenced by facsimile)

______________________________________________________________________

WE RESERVE THE RIGHT TO REFUSE SERVICE TO ANYONE.

Please fill out this form, print it and fax to: 318-254-1198. This form cannot be submitted via the Internet.