First Name *

Last Name *

Phone *

Date Of Birth - mm/dd/yy *

Guest #2 Name: (If Applicable)

Guest #2 Phone # (If Applicable)

Current Address:

Address *

City *

State *

Postal code *

Identification:

Driver's License / ID Number : *

Driver's License / ID Issuing State *

Take Picture Of Front Of ID

Take Picture Of BACK Of ID

Take Personal Picture Of Yourself

Last 4 OF SSN #: (For Each Guest)

Picture Of Front Of ID For #2 Guest (If Applicable)

Vehicle:

Vehicle - Make / Model / Year / Color

Vehicle Tag Number

Income:

Current Employer

Current Employer Address

Current Employer Phone Number

Length Of Time At Current Employer

Income Amount #1: (Place The Amount Of Income Here From Current Employer)

Income Amount Is:

Gross

Net

Income Amount Frequency:

Weekly

Bi-Weekly

Monthly

Yearly

Income Amount #2

Income Amount Verification Here- Submit A Copy Of Check Stubs or Bank Statement

Income Amount Verfication - (Check Stubs or Bank Statements )

References:

Relative Name: *

Relation To Relative: *

Relative Address

Relative Phone Number: *

Emergency Contact: *

Emergency Contact Phone Number: *

Relation To Emergency Contact *

Background:

Have you ever been found guilty of a felony? *

If Yes To If Ever Found Guilty Of Felony, Explain Below :

How Did You Hear About Us? *

I authorize the owner to contact past and present landlords, employers, creditors, credit bureau, neighbors and any other sources deemed necessary to investigate applicant.

All the information is true, accurate and complete to the best of applicant's knowledge. Owner reserves the right to disqualify if information is not as represented.

ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FORM AT ANY TIME.

Agree To Peaceful Promise *

I/We Agree To Abide Completely By The Peaceful Promise.

Agree To Rules *

I agree to All of The Rules and Guidelines posted on the lodging establishment wall.

Understanding *

I Completely Understand that this is a Lodging Establishment and if nay rules or guidelines are broken, I may be required to leave immediately (ejection). There will not be any refunds given.

SMS Consent *

Opt In to Receive SMS Notifications, Alerts & Occasional Marketing Communication

Guest #1 Signature:: *

Clear

Guest #2 Signature: (If Applicable)

Clear

Please Fill Out The Following Information