Landlord
Landlord Name: Edward M. Claffey
Address: 2525 O'Connell Rd. LaFayette, NY 13084
Phone: (315) 677-5445

Rental Property Information
      Rental Property Address: ________________________#____,Syracuse NY 13210
    Anticipated Possession Date: ___________________________________________
The term of the tenancy will be: ___________________________________________
The monthly rent will be $__________       The initial security deposit will be $__________

Applicants' Personal Information

Applicant's Name:  
Home Phone: (          ) Cell Phone: (          )
Email Address:   Date of Birth:  
Applicant's Social Security Number:    

Second Applicant's Name:  
Second Applicant's Date of Birth:  
Second Applicant's Social Security Number:      

Third Applicant's Name:  
Third Applicant's Date of Birth:  
Third Applicant's Social Security Number:      

Do you have a pet?      Yes / No       If more than one, how many? _______      Please describe type(s) of pet(s):
 
 
Residential History
Present Address:  
City:   State:  
ZIP Code:   How long at this address?  
Landlord / Lessor:   Phone: (          )

Previous Address 1:  
City:   State:  
ZIP Code:   How long at this address?  
Landlord / Lessor:   Phone: (          )


Details of Employment

Employer:  
Position:   Date Hired:  
Supervisor's Name:   Phone: (          )
Salary: