Rent To Own - Boise, ID

GENERAL INFORMATION
APPLICANT		CO-APPLICANT
First Name:		First Name:
Last Name:		Last Name:
Date of Birth:	(mm/dd/yyyy)	Date of Birth:	(mm/dd/yyyy) *
Address 1:		Address 1 (if different):
Address 2:		Address 2:
City:		City:
State:		State:
Zip:		Zip:	*
Telephone:		Telephone:	*
Email Address:		Email Address:	*
Social Security #:		Social Security #:	*
Filed for Bankruptcy?:	YesNo	Filed for Bankruptcy?:	YesNo
If Yes - Date Filed:	(mm/dd/yyyy)	If Yes - Date Filed:	(mm/dd/yyyy) *
INCOME INFORMATION
Employer:		Employer:
Monthly Pretax Income:		Monthly Pretax Income:	*
Combined Total Monthly Rent:
OTHER INFORMATION
How did you hear about the HELP Program?:
Optional information about you or the house you are looking for: location; bedrooms; square footage; etc.:
Applicant(s) consent for The HELP Program to run a credit report for the purpose of evaluating credit risk.