1421 Old Gallatin Road, Scottsville, KY 42164
270-237-4287
HomeHousing Application
Applicant:
Co-Applicant:
Birthday:
Birthday:
Phone Number:
Phone Number:
Pay Rate:
Pay Rate:
Employer:
Employer:
Brittani Shelton - Principal Broker
Caleb Shelton - Principal Auctioneer
How long there?
How long there?
Previous Employer:
Previous Employer:
How long there?
How long there?
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?
Proposed Occupants:
Proposed Pet(s):
Breed or Type:
How many?
Monthly Payments:
Other Payments:
Repossession?
Questionnaire:
Have you ever been sued for unpaid bills?
Do you have the total move-in amount available now? (Deposit & Rent)
Have you filed for 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 the sheriff?
Have you ever been brought to court by landlord?
Have you ever moved owing rent?
Have you ever moved & left damage to a property?
Which property / properties are you interested in?
Emergency Contact: Please list someone not living in same household.
Additional Info / Comments:
***Please note that Proof of Income is required with all applications. You may send by email to lori@universalra.com, fax to 270-237-4427, or drop it off that the office.***
Applicant Signature
Co-Applicant Signature
