EMPLOYMENT INFORMATION:
Applicants Employment Status ___ Full Time ____ Part Time ____ Student ____ Unemployed
Employer______________________________________________________________________
Address ______________________________________________________________________
Job Title ___________________________ Dates employed ____________________________
Supervisor Name _________________________ Phone (
) ___________________________
Monthly Pay __________________
If you would like us to consider other sources of income for this Rental Application, please list the amount
and the person we may contact for confirmation. Please do not reveal alimony, child support, or anyone
else’s income unless you want us to consider it in this Oregon Rental Application.
Amount $_____________________________________________________________________
Contact Name _________________________________________________________________
RESIDENTIAL HISTORY FOR LAST 3 YEARS:
Current Address _______________________________________________________________
Move In Date ________________________ Rent $____________________________________
Owner/Agent _________________________________________Phone (
) _____________
Reason for Leaving _____________________________________________________________
Previous Address ______________________________________________________________
Move In Date ______________ Move Out Date ______________ Rent $__________________
Owner/Agent _________________________________________Phone (
) _____________
Reason for Leaving _____________________________________________________________
Previous Address ______________________________________________________________