"If I Don't Take Care Of My
Customers, Somebody Else Will!"
  

About Jim Russell

Lease Application

 
Email Address:

         What Property Are You Interested In (if known): 

 
Applicant's Name:  
D.O.B Home #
    Cell #
       
Spouse's Name:
D.O.B    
        
Present Address
Landlord: Landlord Phone:
Landlord Address
         
OTHER PERSONS THAT ARE TO OCCUPY THE PREMISES APPLIED FOR:
Name: Relationship: D.O.B.
Name: Relationship: D.O.B.
Name: Relationship: D.O.B.
Name: Relationship: D.O.B.
 
APPLICANT EMPLOYMENT:

Employed By:

Position:

How Long:

Gross Monthly Income:

Business Address:

Supervisor's Name:

Supervisor's Phone::

    
SPOUSE EMPLOYMENT:

Employed By:

Position:

How Long:

Gross Monthly Income:

Business Address:

Supervisor's Name:

Supervisor's Phone::

   
PERSON TO NOTIFY IN CASE OF EMERGENCY:
Name: Relationship: Phone:.
Address
 
Do You Have Pets: Pet Type:
  

Have you ever been evicted?

If "YES" give details:

    

Have you ever been convicted of a felony?

If "YES" give details:

 
 
By Checking This Box, I Hereby Digitally Sign This Form
Re-type Name:
  
Jim Russell Properties, LLC
10703 Chain Ivy Ct
Louisville, KY 40291
494-8100 / 416-0545 (Fax)
JimRussellRealtor.com
   
 
 
 
   

 

Privacy Statement: Your privacy is important to those of us at Jim Russell.  For this reason, the information you provide us above will only be used by Jim Russell.  It is our policy to NEVER sell or give this information to any company, organization, or individual - period!

 

 


 

Jim Russell, Realtor - All Rights Reserved
  
RE/MAX Action First
 1601 Business Center Ct
 Louisville KY 40299
Jim Russell Properties, LLC
Personal Office
1730 Gagel Ave
Louisville KY 40216
    
Phone: 502.494.8100 ∞ Fax: 502-416-0545
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