RENTAL APPLICATION
Equal Housing Opportunity

LUCKY SAND DOLLAR REALTY
t. 239-368-1017, f. 888-679-5775,


The undersigned hereby makes an application to rent the following property:
  • Please enter the property address you applying for.
  • Please indicate advertized rental price
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    Please indicate when you would like to start the lease
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  • Put NA if unemployed
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  • $
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  • Please indicate all additional income to support your application
  • You Must Indicate at Least One Personal Reference or Emergency Contact (Name, Relationship and Phone Number):
  • Please List All Vehicles you Have (Year, Make, Model, Plate Number)
  • Email or phone please.
  • I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application. When so approved and accepted, I agree to execute a lease for 12 months before possession is given and to pay the balance of the security deposit prior to the move in date. If the application is not approved or accepted by the owner or agent, the deposit will be refunded, the application hereby waiving any claim for damages by reason of non-acceptance which the owner or agent may reject. I recognize that as a part of your procedure for processing my application, and investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. The above information, to the best of my knowledge, is true and correct.

    AUTHORIZATION Release of Information
    I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house, apartment, or condominium from this owner/manager.
    By clicking submit button you stating, to the best of your knowledge, information provided above is true and correct and agree to the Terms and Conditions of this application:
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