Address:
Dube Investment Properties, LLC
30 Temple St., #205
Nashua, NH 03060

Phone: (603) 883-1313
Fax: (603) 883-1717

Email: info@dubeproperties.com

Click to email the following people:
William Dube
Gene Lonergan
Donna Griffin

Rental Application

You can find a list of our Rental Policies in our:
Lease-Rental Agreement and Deposit Receipt
Lease-Rental Agreement Addendum

If you would like a downloadable version of this application, please click here. (663 Kb)

Type and Size of Apartment Wanted:
Desired Date of Occupancy:

PERSONAL INFORMATION
 
Applicant's Full Name:
Date of Birth:
Address:
City:
State:
Zip:
Social Security Number:
Co-Applicant's Full Name:
Date of Birth:
Address:
City:
State:
Zip:
Social Security Number:
    Other Resident 1:
    Other Resident 1 Relationship: DOB:
    Other Resident 2:
    Other Resident 2 Relationship: DOB:
    Other Resident 3:
    Other Resident 3 Relationship: DOB:
Do You Own Furniture:
Pets:
Other Remarks:

RESIDENCE HISTORY
 

APPLICANT
 
Present Address:
City:
State:
Zip:
Present Telephone:
Length of Time at Present Address:
Present Landlord or Mortgage Holder:
Amount of Rent:
Reason for Moving:

CO-APPLICANT
 
Present Address:
City:
State:
Zip:
Present Telephone:
Length of Time at Present Address:
Present Landlord or Mortgage Holder:
Amount of Rent:
Reason for Moving:

EMPLOYMENT INFORMATION
 

APPLICANT
 
Employed by:
How Long:
Employer's Address:
Telephone:
Position Held:
Supervisor:
Salary: per

CO-APPLICANT
 
Employed by:
How Long:
Employer's Address:
Telephone:
Position Held:
Supervisor:
Salary: per

BANKING AND CREDIT REFERENCES
 
Bank:
Branch:
Checking Account Number:
Savings Account Number:
Credit Reference 1:
Account Number 1:
Address 1:
Credit Reference 2:
Account Number 2:
Address 2:

OTHER INFORMATION
 
Number of Automobiles:
Driver's License Number:
    Vehicle 1 Make and Model:
    Vehicle 1 Year:
    Vehicle 1 Color:
    Vehicle 1 Tag Number:
    Vehicle 1 State:
    Vehicle 2 Make and Model:
    Vehicle 2 Year:
    Vehicle 2 Color:
    Vehicle 2 Tag Number:
    Vehicle 2 State:
    Vehicle 3 Make and Model:
    Vehicle 3 Year:
    Vehicle 3 Color:
    Vehicle 3 Tag Number:
    Vehicle 3 State:
Other Remarks:
In Case of Emergency, Notify:
Relationship:
Address:

GOOD FAITH DEPOSITS
 
I hereby deposit:
with Management as a good faith deposit in connection with this rental application. If my application is accepted, I understand this deposit will be applied toward payment of my
security deposit of:
when I take possession of the apartment. If for any reason Management decides to decline my application, the Management will refund this good faith deposit to me in full. I understand I may cancel this application by written notice within 48 hours and receive a full refund of this good faith deposit within 30 days of cancellation. If I cancel after 48 hours or refuse to occupy the premises on the agreed upon date, I understand this good faith deposit will be held until Management can determine if it has incurred any expenses or rent loss due to my cancellation. This cost will be deducted from this good faith deposit and the balance will be refunded to me.

I hereby make application for an apartment and certify that the above information is correct.
I authorize you to contact the references that I have listed and to perform a credit check.
APPLICANT'S SIGNATURE: ***
Email Address:
CO-SIGNED: ***
DATE SIGNED:
 

*** By submitting this form, you are submitting a "virtual signature" verifying that the above is true and correct. Any form filled out and sent to us via email with a virtual signature will be considered a signed document and you will be bound by any terms and conditions set forth in the document itself.