Please fill out this information completely, print and bring to the meeting for approval.
Initials are required at the bottom of this page
from both the primary and co-applicants (if applicable). Required fields are marked with
an asterisk (*).
First Name:* __________________
Last Name:* __________________
Today’s Date:* ________________
Street Address:* ______________________________
City:* _______________________
State/Province/Region:* _________
Previous Address (last three years), Street:* _________________________
City: *______________________
State/Province/Region:*________
Postal/Zip Code:*_____________
Home Phone:* _______________
Cell Phone: *_________________
Work Phone:* ________________
Email Address:*____________________________
Date of Birth:* ________________
Social Security #: _____________________
Current Monthly Lease/Rent Payment:* ____________
Monthly lease amount I can afford:* _______________
Do you have a deposit readily available? Please select amount:* _________________
Areas of Interest: ________________________
Employment Status:* ______________________
Who is your employer?*______________________
When did you begin employment there?______________________________
What is your gross monthly income? (before taxes)*______________________
If Self-Employed, what is your NET monthly income? (verification will be required)*_______
Monthly minimum charge card payments: (if none, please write N/A)* ________________
What is the total monthly amount of ALL loan payments?* (include auto, mortgage, student,
personal, and any others) If none, please write N/A ______________
Have you had a prior foreclosure, bankruptcy, or repossession? If so, when?*__________
Additional information you would like us to consider: ____________________________
Co-Applicant Information: If you are the only applicant, please scroll down to the bottom
of the page to acknowledge the application by initialing where indicated. If there is a
co-applicant, please check box and fill on all information completely.
First Name:* ________________
Last Name:* ________________
Street Address:* __________________________________
City:*______________________
State/Province/Region:* _______
Previous Address (last three years), Street:* _________
Postal/Zip Code:*_____________
Home Phone:* _______________
Cell Phone:* _________________
Work Phone: *________________
Email Address:*______________________________
Date of Birth:*________________
Social Security #:*______________
What is your gross monthly income? (before taxes)*_____________________
If Self-Employed, what is your NET monthly income? (verification will be required)*_______
Other sources of income we could consider (i.e. Social Security, disability,
child support, etc.)* _______________
Monthly minimum charge card payments: (if none, please write N/A)*_______________
What is the total monthly amount of ALL loan payments? (include auto, mortgage,
student, personal, and any others) If none, please write N/A* _____________________
Have you had a prior foreclosure, bankruptcy, or repossession? If so, when?*_________
Initial for AUTHORIZATION Release of Information: By initialing this application,
I/we agree to permit an investigation of my/our credit, tenant history, banking and
employment for the purpose of renting an apartment or house with this owner/manager.
Primary Applicant: I agree to permit an investigation of my credit, tenant history, banking
and employment for the purposes of applying to the Any Credit Idaho Program.
Please place you initials here*. ______
Co-Applicant: I agree to permit an investigation of my credit, tenant history, banking and
employment for the purpose of applying to the Any Credit Idaho Program. Please
place your initials here*. _________