3812 North Monroe
Spokane, WA 99205

 R.W. DICKERSON MANAGEMENT & COMPANY, INC
APPLICATION TO RENT

(509)327-0136

"CASH ONLY"

TO BE COMPLETED BY EACH ADULT OCCUPANT.
MARRIED COUPLES ARE TO PROVIDE ONLY ONE APPLICATION PER COUPLE.
PLEASE PRINT APPLICATION MUST BE LEGIBLE AND COMPLETELY FILLED OUT

Property Address: _________________________________________________ Date Desired:__________________

Name: (Last, First, Middle)___________________________________________ Phone:________________________

Social Security #: ____________________________________ Date of Birth: _______________________________

Driver License #: ____________________________________ State: _____________________________________

Spouse's Name(Last, First, Middle):_____________________________________ Phone: _______________

Spouse's Social Security #:_____________________________________ Spouse's Date of Birth: _______________

Spouse's Driver License #: _____________________________________ State: ______________________

Auto (Year, Make, Color, License No., State): _________________________________________________________

Auto (Year, Make, Color, License No., State): _________________________________________________________

OCCUPANTS OTHER THAN APPLICANT:

Name:_________________________ Age: __________ Name:__________________________ Age:_____________

Name:_________________________ Age: __________ Name:__________________________ Age:_____________

PETS

NUMBER OF PETS:________________

Type: ____________________________ Breed: __________________ Weight: ________________ Age:_________

Type: ____________________________ Breed: __________________ Weight: ________________ Age:_________

PERSON TO CONTACT IN EMERGENCY

Address: _____________________ City: ______________ State: ____ Phone: __________ Relationship: ________

RESIDENCE HISTORY

1. Present Home Address: _________________________ City:_________________ State: ____ Zip: ___________

Rent: $_________ Deposit: $__________ Lease or M/M: ________ Move in Date/Date out:____________________

Present Landlord:_________________ Landlord's Address: _________________________ Phone #:_____________

2. Previous Home Address: _________________________ City:________________ State:_____ Zip:____________

Rent: $_________ Deposit: $__________ Lease or M/M: ________ Move in Date/Date out:____________________

Previous Landlord:________________ Landlord's Address: ________________________ Phone #:______________

EMPLOYMENT HISTORY

1. Present Employer:_______________________ Address:_________________________ Phone:___________

Position:___________ Supervisor:_____________ Hrs/week:______ Wage:_____ Start Date:______ End Date:_______

2. Previous Employer:_______________________ Address:_________________________ Phone:__________

Position:___________ Supervisor:_____________ Hrs/week:______ Wage:_____ Start Date:______ End Date:_______

3. Spouse's Employer:_______________________ Address:_________________________ Phone:__________

Position:___________ Supervisor:_____________ Hrs/week:______ Wage:_____ Start Date:______ End Date:_______

CREDIT REFERENCE
Bank or Local Business

Name: ___________________ Address:___________________ Acct #:_______________ Phone:_______________

DEBTS & LIABILITIES
Charge Accounts, Loans, and Other Payments

Type:_______ Bank or Company:_____________ Acct #: ___________ Balance Owing:______ Mnthly Amt:______

Type:_______ Bank or Company:_____________ Acct #: ___________ Balance Owing:______ Mnthly Amt:______

INCOME AND ASSETS

Monthly Wages $:___________________ Other Monthly Income:_________________________________________

Checking Account

Bank: ________________________ Branch:__________________ Account Number: _________________________

Savings Account

Bank: ________________________ Branch:__________________ Account Number: _________________________

Have you ever filed a petition in bankruptcy? __________________ Date:__________________________________

Why? _________________________________________________________________________________________

Why are you moving?_____________________________________________________________________________

_______________________________________________________________________________________________

Have you ever been convicted of a misdemeanor or felony?________________ Explain:______________________

_______________________________________________________________________________________________

Have you ever been convicted or had a dispute with a landlord?________________Explain: ___________________

_______________________________________________________________________________________________

Applicant/Co-Applicant certify that the information provided herein is true and that any false information knowingly provided is subject to the penatly of perjury. Applicant/Co-Applicant hereby authorize the landlord and/or agents to verify the information and obtain credit reports, criminal background, unlawful detainer, prior eviction information, past tenancy reports and employment verification through Credit Bureau Services or directly from third party sources. Applicant/Co-Applicant will not keep or harbor animals or pets of any kind on the premises without the written permission of the landlord. If written permission is given, the cleaning, damage, and security deposit will be increased at the landlord's discretion. Application/Co-Applicant agrees that the landlord may terminate any agreement entered into in reliance on any misstatement made herein.

Applicant/Co-Applicant will furnish landlord with a pictured driver's license, or current pictured identification.

A holding fee shall be collected upon approval of application to rent. Upon signing of the Holding Fee Agreement, should Applicant/Co-Applicant wish not to rent this property (as stated on page 1), the full holding fee shall be held by R.W. Dickerson Management. The Applicant/Co-Applicant will pay all COST INVOLVED in the re-renting of the aforementioned property. Applicant has recieved a vopy of Rental Agreement Addendum "A" defining rental. Application requirements, criteria, definition, and qualification either by web site of, official visit, agent, landlord presentation with application and hereby agree to all rental requirement terms for any and all rentals.

A color copy of your driver license must accompany each application. Applicant/Co-Applicant agrees to pay a $40.00 NON-REFUNDABLE Application Fee. THE APPLICATION CANNOT BE PROCESSED UNTIL THIS IS RECEIVED.

IF APPLICATION IS NOT COMPLETED CORRECTLY LEGIBLE - IT WILL NOT BE PROCESSED

Applicant____________________________________________________ Date_______________________________

Applicant____________________________________________________ Date_______________________________


R.W. DICKERSON MANAGEMENT & COMPANY, INC.
RENTAL APPLICATION ADDENDUM "A".
RENTAL APPLICATION REQUIREMENTS, CRITERIA, DEFINITIONS, AND QUALIFICATIONS.
ALL PERSONS ARE ENCOURAGED TO APPLY FOR ANY AND ALL RENTALS SUPPLIED BY R.W. DICKERSON

THE ONLY RENTAL AGREEMENT FOR ANY RENTAL TERMS, PAYMENTS OR AGREEMENTS WILL BE OFFERED SOLELY BY R.W. DICKERSON MGMT. & CO., INC.

R.W. DICKERSON MANAGEMENT & CO., INC. IS A WASHINGTON STATE LICENSED REAL ESTATE COMPANY. THIS COMPANY, BY AGENCY LAW, IS BOUND TO WORK AND RENT ALL REAL ESTATE FOR THE BEST INTEREST OF THE OWNERS.

Rental Applicant Requirements
  1. FULLY COMPLETED RENTAL APPLICATION, ONE (1) PER ADULT** APPLICANT. MARRIED COUPLES COMPLETE ONE (1) APPLICATION. ADULT (S) REQUIRING LIVE-IN SUPERVISIOR/GUARDIAN OR 24 HOUR CARE: SUPERVISIOR/GUARDIAN/CARE GIVER(s) MUST COMPLETE AN APPLICAITON (S).
  2. $40.00 CASH (EXACT AMOUNT), NON-REFUNDABLE APPLICATION FEE PER APPLICATION MUST BE PAID AT THE TIME THE APPLICATION IS SUBMITTED FOR R.W. DICKERSON MGMT. & CO., INC., TO COMPLETE THE PROCESS.
  3. ALL APPLICATIONS WILL BE CONSIDERED FOR RENTAL APPROVAL UPON FULL PROPER COMPLETION AND PAYMENT.

ALL APPLICATIONS WILL BE REVIEWED FOR THE FOLLOWING ITEMS:
  • CURRENT AND PRIOR LANDLORD REFERENCES
  • CURRENT AND PRIOR EMPLOYMENT / INCOME VERIFICATION
  • CREDIT HISTORY
  • PETS
  • CRIMINAL CONVICTIONS

CRITERIA FOR APPLICATION APPROVAL
  • POSITIVE RENTAL REFERENCES** FROM BOTH CURRENT AND PRIOR LANDLORDS, PLUS ANY FURTHER VERIFICATION DEEMED NECESSARY BY THE MANAGEMENT COMPANY.
  • MINIMUM MONTHLY INCOME OF TWICE (2X) THE MONTHLY RENT OF THE PROPERTY BEING APPLIED FOR, THREE TIMES (3X) PREFERRED
  • CREDIT REPORT "BEACON SCORE"** OF 475 OR ABOVE**.
  • MINIMAL UNPAID COLLECTIONS OR JUDGMENTS ON CREDIT REPORT. UNPAID COLLECTIONS and/or JUDGMENTS MAY DISQUALIFY APPLICANT (S).
  • DOGS OVER 20LBS AND CATS MAY DISQUALIFY APPLICANT. SERVICE ANIMALS ARE WELCOME. MUST PROVIDE DOCTOR ORDERS AND ACCREDITATION CERTIFICATE FOR EACH ANIMAL. NO DANGEROUS BREEDS ALLOWED.
  • VERIFIED INCOME SOURCES: Employer, Award letters for Social Security, SSI, Financial Aid, Unemployment, Scholarships, etc.
  • SELF-EMPLOYED INDIVIDUALS: must provide their last two (2) year's Income Tax returns to verify Self-employment income.
  • VERIFIED NON-INCOME SOURCES: Education Grants, Food Stamps, Loans, gifts, etc.
  • CRIMINAL CONVICTIONS MAY DISQUALIFY APPLICANT (S).

IF APPLICANTS DO NOT MEET OUR MINIMUM REQUIREMENTS AND EXTENUATING CIRCUMSTANCES EXIST, THE APPLICANTS MAY BE APPROVED, AT THE MANAGEMENT COMPANY'S SOLE DISCRETION, IF THEY ARE ABLE TO PROVIDE A QUALIFIED CO-SIGNER** OR IF THEY ARE ABLE TO PAY TWICE (2X) THE NORMAL DEPOSIT AND THREE (3X) TIMES (First, & last 2 month's rent) THE NORMAL MONTHLY RENT---OR BOTH---AT THE TIME THEY ARE GIVEN POSSESSION OF THE PROPERTY.

PRIOR TO APPLICATION, A GENERIC RENTAL AGREEMENT MAY BE REVIEWED IN THE MANAGEMENT COMPANY OFFICE, 8AM TO 5PM, MONDAY THROUGH FRIDAY, AT THE DISCRETION OF ANY PROSPECTIVE TENANT.

** SEE DEFINITIONS

DEFINITIONS
ADULT: ALL PERSONS OVER THE AGE OF 18 ARE CONSIDERED A LEGAL AGE ADULT AND MUST FILL OUT A SEPARATE APPLICATION EVEN IF THEY ARE DEPENDENTS OF ADULT APPLICANT(S).
BEACON SCORE: A RATING SCORE USED BY EQUIFAX CREDIT INFORMATION SERVICES TO PREDICT THE LIKELIHOOD THAT A POTENTIAL CREDIT CUSTOMER WILL BECOME A SERIOUS CREDIT RISK WITHIN THE NEXT 24 MONTHS. SCORES RANGE FROM 350 TO 950, THE LOWER THE SCORE, THE HIGHER THE POTENTIAL CREDIT RISK.
EMPLOYMENT HISTORY: A MINIMUM OF THREE (3) MONTHS WITH CURRENT EMPLOYER OR HISTORY OF EMPLOYMENT IN SIMILAR POSITIONS.
POSITIVE RENTAL REFERENCE:
  • RENT REGULARLY PAID ON TIME, NO LATE RENTS
  • TENANTS GAVE PROPER NOTICE TO VACATE
  • POSITIVE LANDLORD COMMENTS, I.E.; WOULD RENT TO AGAIN, TOOK CARE OF PROPERTY, NO PROBLEMS GOOD TENANTS, ETC.
  • NO NEGATIVE LANDLORD COMMENTS
  • NO TENANT CAUSED PROPERTY DAMAGE
QUALIFIED CO-SIGNER: ADULT RELATIVE (Father, Mother, Grandparent(s), Brother, Sister) WHO OWNS REAL PROPERTY IN THE STATE OF WASHINGTON AND MEETS THE MANAGEMENT COMPANY’S INCOME AND CREDIT REQUIREMENTS AS SET FORTH HEREIN.

QUALIFYING CRITERIA

THE FOLLOWING ITEMS WILL AUTOMATICALLY DISQUALIFY AN APPLICANT IF EXPLANATIONS ARE NOT PROVIDED WITH THE APPLICATION:

  • IRS LIENS AGAINST APPLICANT
  • DSHS CHILD SUPPORT LIEN AGAINST APPLICANT
  • DWI CONVICTION
  • 10 OR MORE UNPAID COLLECTIONS TOTALING $1000.00 OR MORE
  • DEBT TO INCOME RATIO ABOVE 75%
  • NOTE: MEDICAL COLLECTIONS ARE CONSIDERED UNAVOIDABLE AND WILL NOT AUTOMATICALLY DISQUALIFY AN APPLICANT.
ALL LETTERS OF EXPLANATION ARE ACCEPTED WITH APPLICATIONS. THESE MAY OR MAY NOT INFLUENCE OUR DECISION.
BANKRUPTCIES WILL NOT NECESSARILY DISQUALIFY AN APPLICANT; HOWEVER, THE BANKRUPTCY MUST BE FULLY DISCHARGED. IF APPLICANT HAS AT LEAST FIVE (5) LATE PAY OR UNPAID DELINQUENT ACCOUNTS AFTER BANKRUPTCY DISCHARGE, THEIR APPLICATION IS SUBJECT TO DENIAL.
RESIDENTIAL ADDRESSES SHOWN ON APPLICANT’S CREDIT REPORT THAT ARE NOT DISCLOSED ON THE APPLICATION WILL BE QUESTIONED AND MAY HAVE AN ADVERSE EFFECT ON THE APPLICANT’S RENTAL APPROVAL.
A MINIMUM OF ONE (1) YEARS RENTAL HISTORY, EXCLUDING RENTAL HISTORY FROM FAMILY MEMBERS, IS REQUIRED.
CREDIT DEBIT (PLUS PROPOSED RENT) TO INCOME RATIO, AS DETERMINED FROM THE APPLICANT’S CREDIT REPORT AND APPLICATION, SHOULD BE NO GREATER THE 75% OF THE APPLICANTS GROSS INCOME.

FALSE, INCORRECT, OR MISLEADING STATEMENTS REGARDING INCOME, CREDIT, RENTAL OR CRIMINAL HISTORY WILL BE GROUNDS FOR DENIAL.

APPLICANTS HAVE THE RIGHT TO DISPUTE ANY ADVERSE INFORMATION OBTAINED.
  • IF THIS WAS INFORMATION OBTAINED BY THE CREDIT BUREAU SERVICE AFFILIATED WITH ACRANET CREDIT INFORMATION SERVICES, YOU HAVE THE RIGHT TO REQUEST A FREE COPY OF YOUR CREDIT REPORT FROM ACRANET THE INFORMATION NETWORK, 521 W. MAXWELL/P.O. BOX 5396, SPOKANE, WA 99205-0393 (509) 324-1350 OR 1-800-845-7435. YOU HAVE THE RIGHT TO DISPUTE, DIRECTLY WITH THE CREDIT REPORTING AGENCY, THE ACCURACY OR COMPLETENESS OF ANY INFORMATION REPORTED BY THE CREDIT REPORTING AGENCY.
  • IF THIS WAS INFORMATION OBTAINED FROM THIRD PARTY SOURCES, YOU HAVE THE RIGHT TO OBTAIN DISCLOSURE OF THE NATURE OF THAT INFORMATION BY MAKING A WRITTEN REQUEST TO OUR OFFICE WITHIN 60 DAYS OF YOUR APPLICATION BEING DENIED.

R.W. DICKERSON MANAGEMENT & COMPANY, INC.

RESIDENT'S REASONABLE ACCOMMODATION REQUEST FORM


  1. R.W. DICKERSON MANAGEMENT & CO., INC. is committed to the letter and spirit of the Fair Housing Act that prohibits discrimination against persons with disabilities. In accordance with this Act, R.W. Dickerson Mgmt. & Co., Inc., will make resonable accomodations when necessary to afford persons with disabilities an opportunity to apply for the property at:

    _____________________________________________________________________________________________________

  2. Do you consider yourself to be disabled*? (circle one) YES    NO   If not, please list the member(s) of your houshold who is seeking reasonable accommodation:

    _____________________________________________________________________________________________________

  3. Please describe the accommodation that you are requesting, i.e. a service animal or wheelchair ramp, etc.: ______________________________________________________________________________________________________

    ______________________________________________________________________________________________________ Please attach additional paper if necessary.
    • Please provide the name and address of the qualified individual(s)** who will verify that your request is related to your disability and is necessary for occupancy of the property. A letter from said qualified individual(s) will also be accepted with completed application.

    • __________________________________________________________________________________
        • NAME AND TITLE

    • __________________________________________________________________________________
        • MAILING ADDRESS

    • __________________________________________________________________________________
        • PHONE AND FAX NUMBERS        
      Please attach additional paper with additional names if necessary.

    By signing this agreement the Tenant(s) give permission to R.W. Dickerson Mgmt. & Co., Inc. to contact the above named individual(s) for purposes of verifying this request.

  4. Applicant____________________________________________________Date_____________________________

  5. Applicant____________________________________________________Date______________________________

    6. *The Fair Housing Act defines disability as a physical or mental impairment that substantially limits one or more major life activities. The Supreme Court has determined that to meet this difinition a person must have an impairment that prevents or severly restricts the person from doing acitivities that are of central importance in most peoples daily lives.

    **Qualified indvidual(s) must be a medical doctor or other qualified professional doctor.