I am totally focused on
my client's needs, and I
work to realize their
dreams as if they were
my own.
my client's needs, and I
work to realize their
dreams as if they were
my own.
| Jim Austin 813-238-5959 aii.postlets.com |
CONTACT ME NOW
welcome to:
ABC REALTY
ABC REALTY
Rent To Own Application
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AUSTIN INDUSTRIES, INC. 709 W HILLSBOROUGH AV, TAMPA, FL 33603 (813) 238-5959 (813)238-3636 Fax
APPLICATION FOR RESIDENCY
Non-refundable Application fee $25.00
ADDRESS APPLYING FOR ___________________________
APPLICANT NAME
SOCIAL SECURITY #
DATE OF BIRTH
DRIVERS LICENSE #
MOTHER’S MAIDEN NAME
CO-APPLICANT
SOCIAL SECURITY #
DATE OF BIRTH
DRIVERS LICENSE #
MOTHER’S MAIDEN NAME
PRESENT ADDRESS PREVIOUS ADDRESS
CITY STATE ZIP CITY STATE ZIP
SINCE (M/D/Y) SINCE (M/D/Y)
AMOUNT OF RENT
PRESENT PHONE
WORK PHONE
APPLICANTS EMPLOYER
ADDRESS
CITY STATE ZIP
PHONE
MONTHLY INCOME
HOW LONG EMPLOYED
CO-APPLICANTS EMPLOYER
ADDRESS
CITY STATE ZIP
PHONE
MONTHLY INCOME
HOW LONG EMPLOYED
ADDITIONAL SOURCE OF INCOME
(IE: SSI, CHILD SUPPORT, ALIMONY, 2ND JOB)
CHILDREN NAMES & AGES
BANK REFERENCE
NAME LOCATION PHONE
IN THE PAST 2 YEARS, HAVE YOU HAD:
A BANKRUPTCY?
TO PAY BACK CHILD SUPPORT?
ANY TAX LIENS FILED AGAINST YOU?
HAVE YOU EVER BEEN EVICTED OR FORECLOSED ON?
DO YOU OWE BACK UTILITIES?
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
PETS BREED WEIGHT
CAR TAG# YEAR MAKE MODEL COLOR
Under penalties of perjury I/we do hereby acknowledge that the foregoing answers and explanations are true and complete to the best of
my/our knowledge. I/we do hereby authorize verification of the above information, references, and credit records. I/we acknowledge that
false information herein constitutes grounds for rejection of this application, termination of right of occupancy and/or may constitute a
criminal offence under the Laws of this State EQUAL CREDIT OPPORTUNITY ACT the Federal ECOA prohibits from discrimination
against credit applicants on the basis of sex or marital status. The Federal Agency which administers compliance with this law concerning
this business (Austin Industries, Inc) is the Federal Trade Commission, 1718 Peachtree St., N.W. Room 1000, Atlanta, FA 30308.
Austin Industries, Inc. is a Licensed Mortgage Brokerage business with Licensed Real Estate Brokers upholding the equal housing/lending
laws of the State of Florida. The information contained in this Application for Residency is privileged and confidential information which
is intended for the use of Austin Industries, Inc. and any lender which may involved in this transaction.
_______________________________________________________
_________________________________________________________
Applicant’s Signature (date) Co-applicant’s Signature (date)
APPLICATION FOR RESIDENCY
Non-refundable Application fee $25.00
ADDRESS APPLYING FOR ___________________________
APPLICANT NAME
SOCIAL SECURITY #
DATE OF BIRTH
DRIVERS LICENSE #
MOTHER’S MAIDEN NAME
CO-APPLICANT
SOCIAL SECURITY #
DATE OF BIRTH
DRIVERS LICENSE #
MOTHER’S MAIDEN NAME
PRESENT ADDRESS PREVIOUS ADDRESS
CITY STATE ZIP CITY STATE ZIP
SINCE (M/D/Y) SINCE (M/D/Y)
AMOUNT OF RENT
PRESENT PHONE
WORK PHONE
APPLICANTS EMPLOYER
ADDRESS
CITY STATE ZIP
PHONE
MONTHLY INCOME
HOW LONG EMPLOYED
CO-APPLICANTS EMPLOYER
ADDRESS
CITY STATE ZIP
PHONE
MONTHLY INCOME
HOW LONG EMPLOYED
ADDITIONAL SOURCE OF INCOME
(IE: SSI, CHILD SUPPORT, ALIMONY, 2ND JOB)
CHILDREN NAMES & AGES
BANK REFERENCE
NAME LOCATION PHONE
IN THE PAST 2 YEARS, HAVE YOU HAD:
A BANKRUPTCY?
TO PAY BACK CHILD SUPPORT?
ANY TAX LIENS FILED AGAINST YOU?
HAVE YOU EVER BEEN EVICTED OR FORECLOSED ON?
DO YOU OWE BACK UTILITIES?
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
PETS BREED WEIGHT
CAR TAG# YEAR MAKE MODEL COLOR
Under penalties of perjury I/we do hereby acknowledge that the foregoing answers and explanations are true and complete to the best of
my/our knowledge. I/we do hereby authorize verification of the above information, references, and credit records. I/we acknowledge that
false information herein constitutes grounds for rejection of this application, termination of right of occupancy and/or may constitute a
criminal offence under the Laws of this State EQUAL CREDIT OPPORTUNITY ACT the Federal ECOA prohibits from discrimination
against credit applicants on the basis of sex or marital status. The Federal Agency which administers compliance with this law concerning
this business (Austin Industries, Inc) is the Federal Trade Commission, 1718 Peachtree St., N.W. Room 1000, Atlanta, FA 30308.
Austin Industries, Inc. is a Licensed Mortgage Brokerage business with Licensed Real Estate Brokers upholding the equal housing/lending
laws of the State of Florida. The information contained in this Application for Residency is privileged and confidential information which
is intended for the use of Austin Industries, Inc. and any lender which may involved in this transaction.
_______________________________________________________
_________________________________________________________
Applicant’s Signature (date) Co-applicant’s Signature (date)
Austin Industies Inc.
