Tenant Application

Long Term Rental Application

Please complete and submit the form below to be considered for a Long Term rental. A Dieter Company representative will contact you after reviewing the info. A $50 application fee applies, and your driver's license number is required.

First Name *

Last Name *

Email *

Phone

DOB *

Driver's License # *

State Issued *

List names and ages of everyone (including children) staying in property *

Do you have pets? *

List all Vehicles Make/ Model & License Plate

Current Address *

Landlord/Owner Name and Phone

Employer

Employer Phone

Employer Address *

Supervisor Name

Salary *

Has eviction ever been filed against you? *

Have you ever been convicted of a crime other than a traffic ticket? *

Have you ever filed for bankruptcy? *

Have you ever been turned over to a collection agency? *

Are you a US Citizen? (If not please provide proper documentation) *

Properties/ Location of Interest

Desired location in building (for condos)

How long do you plan to live here? *

Desired Move-in Date *

Price Range *

Lease Length *

Special Requests *