"Le Dock sur le bayou"
c/o 219 Lyons St., Lafayette, LA 70506
ph 337.984.7902 fax 337.991.0599

RENTAL LEASE APPLICATION

The following information will be used ONLY to determine eligibility for apartment rental. Owner/landlord maintains the right to verify information and to accept or reject applicants for any reason. Each adult tenant who will sign rental lease must complete a rental application. Standard lease is six months with renewal option.

Applicant name ___________________________________________________________________________________________________________

Apt. #______________________________________________________ Occupancy date ______________________________________________

Name all persons who will occupy apartment: _________________________________________________________________________________

Applicant DL# ______________________________ State _____________
Present Address __________________________________________________________________________________________________________
How long? ____________________________________ Rent? __________ Own? __________

Phone _____________________________________________________________________________________________________________
Employer ______________________________________________________________ How long? ______________
Title / Position _________________________________________________________ Empl Phone # _________________________________
Gross Wage/salary at least $2,000 per month? ____________Yes ___________ No

Bank name ____________________________________________________________ Acct# _________________________________
Credit refer. Address/Phone _______________________________________________________________________________________

I verify that the information provided herein is accurate to the best of my knowledge.
I understand that no pets and no smoking are allowed in building.
Owner/landlord maintains the right to verify information and to accept or reject applicants for any reason.

Applicant signature _______________________________________________ Date ________________________________