Pickett and Baugh Realty, Inc.

Searching...

Application

Please complete the form below to apply for any of our rental properties.

For help completing this application, contact our property manager at (336)420-4344.

Which property are you applying for? *

E-Mail Address *

Applicant first name *

Middle name *

Last name *

Date of birth *

Co-applicant first name

Middle name

Last name

Date of birth

Applicant Home phone *

Text Message?

Applicant Mobile phone

Applicant Work phone

Present address *

City *

State *

Zip *

Time at present adress (years/months) *

Landlord name *

Landlord phone *

Previous address

City

State

Zip

Time at previous address (years/months)

Previous Landlord name

Landlord phone

Applicant Employer *

Occupation/Title *

Hire date (month/year) *

Employer address *

City *

State *

Zip

Supervisor Name *

Supervisor Phone

Monthly gross Income *

Have you ever filed for bankruptcy?

Has any previous landlord filed for eviction due to past due rent?

By selecting “yes” from the options below, I declare that the foregoing information is true and correct. I authorize its verification and the obtaining of a consumer credit report. I agree that the lessor may terminate any agreement or tenancy based on any false information provided in this application.

Please duplicate the letters and/or numbers you see below to
verify that you are a valid user of this form.

These are the letters you will duplicate in the box below.

* required field

site administration

site map