Requested Rental Location:
Desired Dates of Stay:
(This is an approximation of how long you will be in the apartment. It does NOT serve as the required 14 day written notice to vacate.)
Number of Bedrooms Needed:
Quoted Rent Amount:
$

Corporate/Company Rental Application

Please Initial each box in this section in acknowledgment:

There is a $85.00 application processing fee that is due in advance to approve client (application can be kept on file for future rentals).* INITIALS

There is a one-time cleaning fee of $125.00 that is due with the first rental invoice.* INITIALS

The applicant understands that the landlord requires a fourteen (14-day) written notice prior to vacating the rental property. * INITIALS

If pet is approved by landlord, pet fee is $300.00 per pet (2-pet maximum with no aggressive breeds allowed). * INITIALS

Pets: * yes no    How many: *      Type/Breed(s): *      Weight(s): *


COMPANY INFORMATION

Company Name:* Company Website:*
Fed. ID# *      Contact Name:
Street Address:
City:       State:      Zip:      Contact Phone:
Company Phone:      Fax:      Email:*
Human Resources Contact:      Phone Number:
Reason for stay: * Temp Need Relocating     Dunn & Bradstreet Number:


RESIDENT INFORMATION

Name:*      Phone:
SSN#      Mobile Phone:      
Present Street Address:
City:      State:      Zip:
Position:      Email:
Supervisor’s Name:      Supervisor’s phone:
Emergency Contact Information:

PAYMENT INFORMATION

*CREDIT CARD REQUIRED BUT DOES NOT HAVE TO USED AS FORM OF PAYMENT*
Deposit Payment :
Rent Payment :     

Name on Card:
Credit Card # (Visa/MC/Discover) *      Exp. Date: *      3 or 4 digit security code: *
Address where you receive the credit card statement: *
City: *      State: *      Zip: *

How did you hear about our service?    Do you need real estate assistance? yes no

By selecting "yes, I agree" below, you acknowledge that the information provided in this application is true and correct to the best of your knowledge. Premier Living Services, Inc. is authorized to make any investigation in your personal, financial and/or credit history through any investigative or credit agencies or bureaus. You also authorize Premier Living Services, Inc. to charge the credit card above.

YES, AGREE



2736 Tyler Rd • Birmingham, AL 35226 • Toll Free 800.987-8828 • Office 205.978-8885 • Fax 205.978-8892 • www.premierliving.com