Residential Lease Application

Property Address (select from drop down menu)

APPLICANT #1

Full Name (First Middle Last):

Driver’s License State & Number:

Date of Birth:

Current Phone Number:

Email:

Employer:

Employer’s Address:

Employer’s Phone Number:

Monthly Net Income (after taxes):

Job Description (title, position, etc.):

Duration with Employer:

Can you provide your two most recent pay stubs as verification of employment? (Yes or No)

APPLICANT #2

Full Name (First Middle Last):

Driver’s License State & Number:

Date of Birth:

Current Phone Number:

Email:

Employer:

Employer’s Address:

Employer’s Phone Number:

Monthly Net Income (after taxes):

Job Description (title, position, etc.):

Duration with Employer:

Can you provide your two most recent pay stubs as verification of employment? (Yes or No)

APPLICANT & OCCUPANT HISTORY

Is either applicant or listed occupants a convicted felon? (Yes or No):

Is either applicant or listed occupants a registered sex offender? (Yes or No):

REFERENCE INFO

Current Address (Street, City, State):

Current Landlord:

Landlord Phone Number:

Duration with Landlord:

Have you ever been evicted? (Yes or No)

If so, when was the most recent occurrence?

Are you in good standing with your current Landlord? (Yes or No)

PET INFO

Do you have pets? (Yes or No):

Quantity:

Animal Type: (Dog / Cat / Bird / etc.):

Breed(s):

Weight(s):

Age(s):

EMERGENCY CONTACT INFO

Emergency Contact Name #1:

Relationship:

Phone Number:

Emergency Contact Name #2:

Relationship:

Phone Number:

OCCUPANT INFO

Full Names of Persons Occupying Unit / Relationship / Age:

AVAILABILITY

How soon are you available to occupy this unit:

DISCLOSURES

* Upon acceptance of premises and signature of lease agreement, tenant will have 3 business days to place all utilities in their name before service is removed from landlord account.

* * By submitting this application with false information, Tenant agrees and understands that Burkhead Realty Holdings, LLC reserves the right to immediately terminate the resulting lease if later discovered. Tenant also agrees to forfeit their security deposit and pay all additional expenses necessary to remove Tenant from the premises, including but not limited to: court fees, legal fees, and management fees.

PRIVACY STATEMENT:All information disclosed on this application is subject to federal privacy laws and will be used only for the sole purpose of screening qualified tenant applicants.

REQUIRED UTILITY DEPOSITS

LAWRENCEBURG PROPERTIES

Allied Waste: Trash collection service. Tel. 1-859-263-2000
Kentucky Utilities: Electric service. Tel. 1-800-981-0600
Lawrenceburg City Water & Sewer: Tel. 1-502-839-5372
Atmos Energy: Gas service. Tel. 1-888-286-6700 / (Emergency for gas leaks 1-866-322-8667)

LEXINGTON PROPERTIES

Fayette County Waste Collection: Service is free to tenants. Owner’s property taxes pay for trash collection. Trash collection is every Thursday. Tel. 1-859-425-2255
Kentucky Utilities: Electric service. Tel. 1-800-981-0600
Kentucky American Water Company: City sewage service is established automatically when water service is activated. Tel. 1-859-269-2386
Columbia Gas: Gas service. Tel. 1-800-432-9345 (call this number in case of gas leaks as well)

FRANKFORT PROPERTIES

Frankfort Plant Board: Electric and water service. Tel. 1-502-352-4501
City of Frankfort: Sewer service. 1-502-875-8500
Atmos Energy: Gas service. Tel. 1-270-685-8069
Columbia Gas: Gas service. Tel. 1-859-288-0227