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Residential Lease Application

Landlord/Lessor: Crystal Clear Property Management LLC Date: April 17, 2026

Application Regarding Location of Residence: [esigwpform formid="169" field_id="0" display="value" ]

PERSONAL INFORMATION

Applicant Name: [esigwpform formid="169" field_id="0" display="value" ]

[esigwpform formid="169" field_id="5" display="value" ]

Current Phone Number: [esigwpform formid="169" field_id="21" display="value" ] Date of Birth: [esigwpform formid="169" field_id="15" display="value" ]

Driver's License Number: [esigwpform formid="169" field_id="13" display="value" ] State of Issuance: [esigwpform formid="169" field_id="9" display="value" ]

Social Security Number: [esigwpform formid="169" field_id="14" display="value" ]

Total Number of Occupants:[esigwpform formid="169" field_id="12" display="value" ]

Occupant Names: (Not including yourself): [esigwpform formid="169" field_id="11" display="value" ]

EMPLOYMENT

Name of Current Employer: [esigwpform formid="169" field_id="17" display="value" ] Supervisor: [esigwpform formid="169" field_id="23" display="value" ]

Address: [esigwpform formid="169" field_id="25" display="value" ] Phone Number: [esigwpform formid="169" field_id="24" display="value" ]

Monthly Pay: [esigwpform formid="169" field_id="26" display="value" ] How long at current job? [esigwpform formid="169" field_id="28" display="value" ]

OTHER

Have you ever filed bankruptcy? [esigwpform formid="169" field_id="52" display="value" ] [esigwpform formid="169" field_id="51" display="label_value" ]

Have you ever been evicted from a rental unit? [esigwpform formid="169" field_id="53" display="value" ] [esigwpform formid="169" field_id="54" display="label_value" ]

If yes, please explain:

Do you smoke? (This provision does NOT imply that smoking is allowed.) [esigwpform formid="169" field_id="57" display="value" ]

How long do you intend to reside here?

Do you have any pets that will occupy the residence either inside or out? [esigwpform formid="169" field_id="58" display="value" ] [esigwpform formid="169" field_id="59" display="label_value" ]

BANK INFORMATION

Bank Name: [esigwpform formid="169" field_id="43" display="value" ] Phone: [esigwpform formid="169" field_id="44" display="value" ]

Routing Number:[esigwpform formid="169" field_id="45" display="value" ] [esigwpform formid="169" field_id="46" display="label_value" ]

Account Number: [esigwpform formid="169" field_id="47" display="value" ] [esigwpform formid="169" field_id="48" display="label_value" ]

Other Sources of Income: [esigwpform formid="169" field_id="49" display="value" ]

REFERENCES

Reference 1: [esigwpform formid="169" field_id="61" display="value" ] Phone: [esigwpform formid="169" field_id="62" display="value" ]

Reference 2: [esigwpform formid="169" field_id="63" display="value" ] Phone: [esigwpform formid="169" field_id="64" display="value" ]

Reference 3: [esigwpform formid="169" field_id="66" display="value" ] Phone: [esigwpform formid="169" field_id="65" display="value" ]

MOTOR VEHICLE INFORMATION

Auto Make/Model: [esigwpform formid="169" field_id="68" display="value" ] Year: [esigwpform formid="169" field_id="70" display="value" ] State: [esigwpform formid="169" field_id="69" display="value" ] Plate Number: [esigwpform formid="169" field_id="71" display="value" ]

Auto Make/Model: [esigwpform formid="169" field_id="72" display="value" ] Year:[esigwpform formid="169" field_id="73" display="value" ] State: [esigwpform formid="169" field_id="74" display="value" ] Plate Number: [esigwpform formid="169" field_id="75" display="value" ]

CONDITIONS AND INFORMATION

[esigwpform formid="169" field_id="78" display="label_value" ]

DISCLOSURES

[esigwpform formid="169" field_id="80" display="label_value" ]

CONSENTS

[esigwpform formid="169" field_id="81" display="label_value" ]

By your signature hereon, you agree that the information disclosed by you herein is true, complete and accurate to the best of your knowledge, and you agree that the information disclosed by you herein is material to the potential Landlord’s decision with respect to granting or denying your application to enter into a lease. April 17, 2026

UPLOAD DOCUMENTS

Please upload a copy of your Driver's License and your most recent Pay Stub or Income Documentation demonstrating your ability to pay the rent.

Drivers License

Pay Stub or Income Documentation

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Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

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February 23, 2021 5:23 pm MDT

Residential Lease Application Uploaded by Marcie Hamling - mabaker718@gmail.com IP 72.208.154.37, 192.88.134.13, 132.148.110.10, 0.0.0.0, 72.208.154.37