Universal Realty & Auction
270-237-4287
1421 Old Gallatin Road, Scottsville, KY 42164
270-237-4287
Housing Application
Applicant:
Co-Applicant:
Birthday:
Birthday:
Phone Number:
Phone Number:
Email Address:
Best way to contact:
Current Address:
Monthly Payment:
How long there?
Current Landlord's Name:
Current Landlord's Phone #:
Previous Address:
Previous Landlord's Name:
Previous Landlord's Phone #:
Monthly Payment:
How long there?
Employer:
Pay Rate:
Employer:
Pay Rate:
How long there?
How long there?
Previous Employer:
Previous Employer:
How long there?
How long there?
Proposed Occupants:
Proposed Pet(s):
Breed or Type:
How many?
Monthly Payments:
Other Payments:
Repossession?
Questionnaire:
Have you ever been sued for unpaid bills?
Have you filed bankruptcy in the last 10 years?
Have you ever been convicted of a felony?
Have you ever broken a lease?
Have you ever been locked out by Sheriff?
Have you ever been brought to court by a landlord?
Have you ever moved owing rent?
Have you ever moved & left damage to a property?
Do you have the total move-in amount available now? (Deposit & rent)
Which property/properties are you interested in?
Applicant Signature
Co-Applicant Signature
Emergency Contact: Please list someone not living in the same household
***Please note that Proof of Income is required with all applications. You may send by email to [email protected], fax to 270-237-4427,
or drop it off at the office.***
Additional Info/Comments:
Brittani Shelton - Principal Broker
