Option Rentals Online Application
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| Date
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| Renters Name
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| Prefix
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| First
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| Last
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| Suffix
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| Co-Renters Name
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| Prefix
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| First
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| Last
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| Suffix
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| Email
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| Sex
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| SSN
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| Co-Renter SSN
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| Birth Date
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| Co-Renter Birth Date
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Previous Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Home Phone
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| Work Phone
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| Cell Phone
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| Co-Renter Cell Phone
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| Drivers License Number and State
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| Expiration Date
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| Co-Renter Drivers License Number and State
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| Co-Renter Expiration Date
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| Employer
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Phone Number
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| Supervisor
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| Job Title
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| PayDay
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| Hire Date
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| Monthly Income
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| Phone Number
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| Supervisor
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| Co-Renters Employer
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Phone Number
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| Supervisor
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| Job Title
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| PayDay
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| Hire Date
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| Monthly Income
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| Vehicle Make, Model and Color
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| License Plate Number and State
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| Co-Renter Vehicle Make, Model and Color
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| Co-Renter License Plate Number and State
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| Current Landlord
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Phone Number
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| Lease Name and Length
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| Lease Expires
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| Personal References - Family
| Enter Name, Relationship, Phone and Address of 2 family members (per renter) to use as personal references.
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| Personal References - Other
| Enter Name, Relationship, Phone and Address of 2 other contacts (per renter) to use as personal references.
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| Other Companies Rented From:
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Release of Address and Employment Information Approval:
Please Read Carefully
Release of Address and Employment Information to Option Rentals, Inc. The signature(s) below indicate consent to the release of my (our) address or location to Option Rentals, Inc. This release will allow the disclosure to Option Rentals, Inc. of information regarding me (us) that is currently in the possession of any agency or department of any government or company or any listed references. I (we) know that there are certain state and federal laws, which protect my (our) right to privacy by restricting access to information held by certain third parties. My (our) signatures below indicate that I (we) have knowingly and voluntarily waived the protection of all state and federal right to privacy laws for the limited purpose of responding to request for information by Option Rentals, Inc
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| Approval of Address and Employment Release:
| Approve Check Box to Approve
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| Renter's Signature
*
| Type Name in Field to Sign and Approve
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| Co-Renter's Signature
| Type Name in Field to Sign and Appprove
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Please Read Carefully:
I certify the information on this form is accurate to the best of my knowledge. I authorize verification of the truthfulness of al information contained herein, including contact with any person, firm or agency listed above and agree to release all parties from any liability or damage that may result. I (we) understand that any false information listed herein may result in Option Rentals, Inc. deciding not to transact business with me (us) at this time.
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| Approval
*
| Approve Check Box to Approve
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| Renter's Signature
*
| Type Name in Field to Sign and Approve
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| Co-Renter's Signature
| Type Name in Field to Sign and Appprove
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Image Verification
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