| Rental Property					 | 
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1022 Porter Ave, Stockton, CA 95207
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 Email ID, First Name, Last Name & Mobile Number must be entered. 
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| Email ID*					 | First Name* | Last Name* | 
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| Date of Birth
					 | Drivers License #					 | Social Sec. No					 | 
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| Home Phone | Mobile*					 | 
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| Second Occupant Information (Occupant above 18 years of age) | 
| Second Occupant First Name | Second Occupant Last Name | Second Occupant Occupation | 
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| Second Occupant Monthly Income | Second Occupant Job Address | Second Occupant Phone Number | 
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| Second Occupant Date of Birth | Second Occupant DL# / SSN | Second Occupant Relationship to Applicant | 
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| Other Proposed Occupants
					 | Date of Birth
					 | Relationship to Applicant
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|  | Current Residence
					 | Previous Residence
					 | Prior Residence
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| Street Address
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| Suburb
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| State and Postcode
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| Last Rent Amount Paid
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| Owner or Agent Name
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| Owner or Agent Phone
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| Reason for leaving
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| Is/Was rent paid in full?
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| Did you give notice?
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| Were you asked to move?
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|  | From/To
					 | From/To
					 | From/To
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| Dates of Residency
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|  | Current Employment
					 | Previous Employment
					 | Prior Employment
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| Employed by
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| Address
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| Employer's phone
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| Occupation
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| Employer Contact
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| Monthly Gross Pay
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					 | From/To
					 | From/To
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| Dates of Employment
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