Residential Rental Application

Walnut Hill Estates, LP
P.O. Box 489

12814 Hwy 70/79 West
Bells, TN 38006
731-663-3339 Office Phone
731-443-2751 Mobile Phone
walnuthillsestateslp@gmail.com
Rental Application
**$40.00 Non-Refundable Application Fee Applies**
**Cash, Cashier’s Check or Money Order Only Payable to
Walnut Hill Estates**
Date____________
Proposed Unit Wanting: House _________Duplex __________ Apartment___________
Applicants Information:
Applicants Name_________________________ Phone Number (cell) __________________
Co-Applicants Name______________________ Phone Number (cell) __________________
Address___________________________________
City, State, Zip_____________________________
Applicants Social Security Number _______________________ Date of Birth ____________
Driver’s License Information- Issuing State ________ DL Number_______________________
Email Address ____________________________________________
Co-Applicants Social Security Number ________________ Date of Birth __________________
Driver’s License Information- Issuing State ________ DL Number______________________
Email Address ____________________________________________

List last 2 places of residency for each Applicant.
Applicant
(1) How long have you lived at your present location? From_________ to ___________
What is your present rental rate per month? _____________
Name of Landlord ______________________________
Address __________________________________________
Phone number________________
(2) From____________ to ______________
Rental rate per month? _____________
Name of Landlord ______________________________
Address __________________________________________
Phone number________________
Co-Applicant
(1) From_____________ to ______________
Rental rate per month? _____________
Name of Landlord __________________________________
Address __________________________________________
Landlord Phone number______________________________
(2) From_____________ to __________________
Rental rate per month? ______________
Name of Landlord ___________________________________
Address ___________________________________________
Landlord Phone Number ______________________________

Employment
List the last 2 Places of employment.
Applicant:
Employer ________________________ Length of Employment __________
Date: From______________________to _______________________
Address/Telephone_________________________________________
Monthly Gross Income ________________
List any additional income you have ___________
Date: From______________________to________________________
Co-Applicant:
Date: From______________________to_______________________
List any additional income you have ______________________
Date: From______________________to_______________________

List All Children whom will be residing with you and ages, this includes children in college.
Name______________________________________ Age____________
Name ______________________________________Age____________
Name ______________________________________Age____________
Personal Reference (Cannot be a Relative)
1._____________________ phone number______________ Address ____________________
Person to contact in case of emergency
Financial Information
Name of Bank __________________________( )
Name of Bank __________________________( )
General Information
Automobile Make, Model and Year
_________________________________________________
License Plate Numbers ________________________
Do you carry insurance for vehicle?______________
Company:______________________________Agent:__________________________________
Phone Number__________________________
Automobile Make, Model and Year
_________________________________________________
License Plate Numbers ________________________
Do you carry insurance for vehicle? ______________
Company:______________________________ Agent__________________________________
Phone Number_______________________
Have you ever been evicted or asked to move? _______________
If yes, Explain_________________________________________________________________
_____________________________________________________________________________
Have you ever been convicted of a felony? ______________________________________
Have you ever been charged with a crime? _______________________________________
Are you a registered sex offender? ______________________________________________
Authorization to Process Application
I _____________________________________ represent that the information provided in this

application is true to the best of my knowledge. You are hereby authorized to verify my credit
and employment and references in connection with the processing of this application.
Date_________________ Signature of applicant_____________________________
Print Name ____________________________________
Date_________________ Signature of co-applicant_____________________________
Print Name ____________________________________

Smoke Free and Pet Free
By signing below I am acknowledging that I understand that ALL Walnut Hill Properties are
smoke free and pet free. Smoking is allowed outside of residence in designated areas ONLY .
Date _______________
Signature of applicant _________________________________________
Print Name ________________________________________________
Date _______________
Signature of co-applicant _______________________________________
Print Name _________________________________________________
Please attach 2 months of proof of income and a copy of your

driver’s license or state issued ID for applicant and co-
applicant.
Application will not be considered for rental of property until all

sections are filled out, application is signed/dated and all
requested documents attached.

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Walnut Hill Estates, LP

P.O. Box 489

Applicants Name_________________________ Phone Number (cell) __________________

Co-Applicants Name______________________ Phone Number (cell) __________________

City, State, Zip_____________________________

Applicants Social Security Number _______________________ Date of Birth ____________

Driver’s License Information- Issuing State ________ DL Number_______________________

Email Address ____________________________________________

Co-Applicants Social Security Number ________________ Date of Birth __________________

Driver’s License Information- Issuing State ________ DL Number______________________

Email Address ____________________________________________

What is your present rental rate per month? _____________

Name of Landlord ______________________________

(2) From____________ to ______________

Rental rate per month? _____________

Name of Landlord ______________________________

(1) From_____________ to ______________

Rental rate per month? _____________

Name of Landlord __________________________________

Landlord Phone number______________________________

(2) From_____________ to __________________

Rental rate per month? ______________

Name of Landlord ___________________________________

Landlord Phone Number ______________________________

Employer ________________________ Length of Employment __________

Date: From______________________to _______________________

Monthly Gross Income ________________

List any additional income you have ___________

Employer ________________________ Length of Employment __________

Monthly Gross Income ________________

Employer ________________________ Length of Employment __________

Monthly Gross Income ________________

List any additional income you have ______________________

Employer ________________________ Length of Employment __________

Monthly Gross Income ________________

Personal Reference (Cannot be a Relative)

1._____________________ phone number______________ Address ____________________

2._____________________ phone number______________ Address ____________________

3._____________________ phone number______________ Address ____________________

Person to contact in case of emergency

1._____________________ phone number______________ Address ____________________

2._____________________ phone number______________ Address ____________________

Name of Bank __________________________( )

Name of Bank __________________________( )

Automobile Make, Model and Year

License Plate Numbers ________________________

Do you carry insurance for vehicle?______________

License Plate Numbers ________________________

Do you carry insurance for vehicle? ______________

Have you ever been evicted or asked to move? _______________

Have you ever been convicted of a felony? ______________________________________

Have you ever been charged with a crime? _______________________________________

Are you a registered sex offender? ______________________________________________

Authorization to Process Application

I _____________________________________ represent that the information provided in this

Date_________________ Signature of applicant_____________________________

Print Name ____________________________________

Date_________________ Signature of co-applicant_____________________________

Print Name ____________________________________

Signature of applicant _________________________________________

Applicants Name_______ Phone Number (cell)

Co-Applicants Name____ Phone Number (cell)

Applicants Social Security Number ___________ Date of Birth

Driver’s License Information- Issuing State DL Number_______________

Co-Applicants Social Security Number Date of Birth __

Driver’s License Information- Issuing State DL Number______________

(2) From to __

(1) From_ to __

(2) From_ to ______

Employer ______________ Length of Employment

Date: Fromto _

Employer ______________ Length of Employment

Employer ______________ Length of Employment

Employer ______________ Length of Employment

1._ phone number Address __

2._ phone number Address __

3._ phone number Address __

1._ phone number Address __

2._ phone number Address __

Date_ Signature of applicant_____________

Date_ Signature of co-applicant_____________