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Universal Case File Number

Field Office Acquiring Evidence

Serial # of Originating Document

Date Received

From 9/11 Law Enforcement Privacy

9/11 Law Enforcement Privacy

To Be Returned D Yes
Receipt Given D Yes
Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e)
Federal Rules of Criminal Procedure
D Yes
Federal Taxpayer Information (FTI)
D Yes

3042-
(Communication Enclosing Material)

Description: EH Original notes re interview of

 APPLIC'TION
1TJO TO RENT
>LEX DATE

IT CALLED TO

t TIME IN

* DATE BACK.

TIME BACK

M.I. (JR.. SR.) PHOtJE NUMBER

Yes/No
SOCIAL SECURITY f DRIVERS LICENSE » ARE YOU OVER 18

PECTTVE RESIDENTS RELATIONSHIP OVER 18 SOCIAL SECURITY*

(or emancipated minor)
Yes/No

Yes/No

lENCES
COMPLEX NAME

STATE ZIP MANAGER'S <

JS ADDRESS - APT* CfrY STATE ZIP MANAGER'S < HOW LONG

COMPLEX NAME RENTS PAID

YOU EVER BEEN DELINQUENT IN PAYMENT OF RENT? PLEASE EXPLAIN

YOU EVER BEEN EVICTED FROM ANY PROPERTY? YES NO ,_^— PLEASE EXPLAIN
\REYOULEAV1NGPRESENTRESIDENCE?
YOU GIVEN NOTICE YET?

OYMENT

WKMOYR
ISOKSNAME YOURPOSmON GROSS SALARY

US EMPLOYER

WKMOYR
1SOR-SNAME YOUR POSmON GROSS SALARY

WKMOYR
ISOR'SNAME YOUR POSITION GROSS SALARY

fOU RECEIVING CHILD SUPPORT? HOW MUCH? $_

fOU RECEIVING A PENSION? HOW MUCH? $_ COMPANY
tt ADDITIONAL INCOME: $
YOU PROVIDE PROOF OF THESE INCOMES?

:E USE ONLY
it Residence Phone Number Called
ng Party Position Length of Residency..
lany NSFs? How many Lates?. Thirty Day Notice Given?_ Rent/Mortgage per Month? J_
lents: Date: Employees Initials

us Residence. Phone Number Called

ng Party Position Length of Residency..
iany NSFs? _ How many Lates?. Thirty Day Notice Given?_ Rent/Mortgage per Month? $_
lents: ' Date: Employees Initials

it Employer _ Phone Number Called Length, of Employment

ngParty_ _ Position of person that Verified. Salary ? J_ WKMOYR
e Paystubs? Yes_ No' Tax Return (s)7 Yes_ No* New Employment 'Offer Letter" required? *_
yee Initials Date:

us Employer, Phone Number Called . Length of Employment

"8 Party- Position of person that Verified. Salary ?$_ WKMOYR

u Paystubs? Yes_ No- Tax Return (s)7 Yes_ No- New Employment 'Offer Letter" required?

yee Initials. Date: . ("Copies must be attached and must be equal to or greater than rental amount)

xial Income Sourc8_ Phone Number Called Length of employment.

ng Party. Proof of Additional Income Attached? (bank statement showing direct deposit, court order of child support,
iy or trust fund, copy of Sodal Security, Disability or Pension Statement, notarized letter of parental support Tax returns or Investment
nents) Employee's Initials Date Comments
Credit References

CHECKING ACCT. BANK ADDRESS/BRANCH PHONE** BRANCH** ACCT. **

CREDIT REFERENCES ADDRESS TYPE ACCT. ACCT.**

CREDrr REFERENCES ADDRESS TYPE ACCT. ACCT.**

Personal References ^p- } "5 2.

NAME ADDRESS
HI'. ota. RELATIONSHIP
"PHONfe **

NAME ADDRESS PHONE** RELATIONSHIP

In Case of Emergency

NAME ADDRESS

RfeXATIONSHIP PHOF(E*f

Automobiles

LICENSE** MAKE MODEL YEAR

LICENSE* MAKE MODEL YEAR

Other Vehicles:

PLEASE NOTE: EVERY ITEM MUST BE FILLED IN AND COMPLETED IN ITS ENTIRETY.
REVIEW YOUR APPLICATION BEFORE YOU TURN IT IN TO THE MANAGER.

THE APPLICANT REPRESENTS THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT AND HEREBY AUTHORIZES
VERIFICATION OF INFORMATION CONCERNING SATO APPLICANT. IT IS UNDERSTOOD THE FEE OF S IS
NOT A DEPOSIT AND WILL NOT BE REFUNDED IF APPLICANT IS DECLINED.

APPUCANT DATE

APPUCANT DATE
 APPLIC TIONTOREN.
'LEX DATE

T CALLED TO

TIME IN

DATE BACK.

TIME BACK

I/ ;M.I. (JR-. SR.) PHONE NUMBER

1
Yes/No
SOCIAL SECURITY* DRIVERS LICENSE* ARE YOU OVER <e

'ECTTVE RESIDENTS RELATIONSHIP OVER 18 SOCIAL SECURITY #

(or emancipated minor)
Yes/No

Yes/No

ENCES
COMPLEX NAME

STATE ZIP

JS ADDRESS APT* CITY STATE ZIP MANAGER'S! HOW LONG

COMPLEX NAME RENT J PAID

YOU EVER BEEN DELINQUENT IN PAYMENT OF RENT? PLEASE EXPLAIN

YOU EVER BEEN EVICTED FROM ANY PROPERTY? YES NO PLEASE EXPLAIN
\RE YOU LEAVING PRESENT RESIDENCE?
YOU GIVEN NOTICE YET?

3YMENT

WKMOYR
YOUR POSITION GROSS SALARY

US EMPLOYER

WKMOYR
YOUR POSITION GROSS SALARY

US EMPLOYER

WKMOYR
/ISOR'SNAME YOUR POSITION GROSS SALARY

fOU RECEIVING CHILD SUPPORT? HOW MUCH? S

VOL) RECEIVING A PENSION? HOW MUCH? $ COMPANY
:R ADDITIONAL INCOME: $
YOU PROVIDE PROOF OF THESE INCOMES?

:E USE ONLY
nt Residence _ Phone Number Called
no. Party Position Length of Residency_
;wnyNSFs?_ How many Lates?. Thirty Day Notice Given?_ Rent/Mortgage per Month? $_
lents: Date: Employees Initials

xa Residence. Phone Number Called

ing Party Position Length of Residency..
rany NSFs? _ How many Lates? _ Thirty Day Notice Given? Rent/Mortgage per Month? $_
nents: Date: ~ Employees Initials

nt Employer. Phone Number Called Length of Employment.

ingParty_ Position of person that Verified _ Salary ? $_ WKMOYR
rePaystubs? Yes No' Tax Return (s)? Yes_ No- New Employment 'Offer Letter* required?'_
>yee Initials Date:.

jus Employer. . Phone Number Called . Length of Employment

ingParty_ Position of person that Verified. , Salary ?$_ WKMOYR

rePaystubs? Yes No'_ Tax Return (s)7 Yes_ No' New Employment 'Offer Letter" required?

>yee Initials _ Date: . ('Copies must be attached and must be equal to or greater than rental amount)

onal Income Source_ Phone Number Called Length of employment.

ing Party. Proof of Additional Income Attached? (bank statement showing direct deposit, court order of child support.
ny or trust fund, copy of Social Security. Disability or Pension Statement, notarized letter of parental support. Tax returns or Investment
nents) Employee's Initials Date Comments
Credit References

CHECKING ACCT. BANK ADDRESS/BRANCH PHONE # BRANCH # ACCT. »

CREDIT REFERENCES ADDRESS TYPE ACCT. ACCT. #

CREDIT REFERENCES ADDRESS TYPE ACCT. ACCT.*

Personal References

PM^LKAl-^V^^l X?^3M644
NAME • A D D R E S S '
?z?^fr&?>
PHOhJF t f RELATIONSHIP

NAME ADDRESS PHONE » RELATIONSHIP

In Case of Emergency

NAME ADDRESS

TIONSHIP PHONE #

Automobiles

JCENSE * MAKE MODEL YEAR

-ICENSE » MAKE MODEL YEAR

Dther Vehicles:

'LEASE NOTE: EVERY ITEM MUST BE FILLED IN AND COMPLETED IN ITS ENTIRETY.
REVIEW YOUR APPLICATION BEFORE YOU TURN IT IN TO THE MANAGER.

HE APPLICANT REPRESENTS THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT AND HEREBY AUTHORIZES
'ERfflCATION OF INFORMATION CONCERNING SATO APPLICANT. IT IS UNDERSTOOD THE FEE OF S IS
IOT A DEPOSIT AND WILL NOT BE REFUNDED IF APPLICANT IS DECLINED.

PPLICANT DATE'

PPUCANT DATE
 APPLIC -HON TO REN".
LEX •fcxCCioogCy DATE

V- CALLED TO

TIME IN

I S>Q DATE BACK

~77fS TIME BACK ]

^ ' ''
. - - _ . l—TfRST " ~ ~ " . M . I . ' (JR.. SR.) PHONE NUMBER

Yes/No
SOCIAL SECURITY« r DRIVERS LICENSE * ARE YOU OVER 1«

'ECTIVE RESIDENTS RELATIONSHIP OVER 18 SOCIAL SECURITY #

(or emancipated minor)
Yes/No

Yes/No

ENCES
COUP LEX NAME

MANAGER'S *

JS ADDRESS *^ APT« CrTY STATE ZIP MANAGER'S* HOW LONG

COMPLEX NAME RENT! PAID

YOU EVER BEEN DELINQUENT IN PAYMENT OF RENT? PLEASE EXPLAIN

YOU EVER BEEN EVICTED FROM ANY PROPERTY? YES NO PLEASE EXPLAIN
\RE YOU LEAVING PRESENT RESIDENCE?
YOU GIVEN NOTICE YET?

OYMENT i

i (—XjixiflJ^i^Jh Rns (_ )
IT EMPLOYER

WKMOYR
YOUR POSITION GROSS SALARY

US EMPLOYER

WKMOYR
/ISOR'SNAUE YOUR POSITION GROSS SALARY

WKMOYR
.1SOIVS NAME YOUR POSITION GROSS SALARY

YOU RECEIVING CHILD SUPPORT? HOW MUCH? $

rOU RECBVING A PENSION? HOW MUCH? $ COMPANY
^ADDITIONALINCOME: $
YOU PROVIDE PROOF OF THESE INCOMES?

:E USE ONLY
nt Residence Phone Number Called.
ng Party Position Length of Residency_
nany NSFs? How many Lates? Thirty Day Notice Given? Rent/Mortgage per Month? $_
tents: Date: Employees Initials

us Residence Phone Number Called

ing Party Position Length of Residency
nany NSFs? How many Lates? Thirty Day Notice Given? Rent/Mortgage per Month? $_
lents: Date: Employees Initials

nt Employer Phone Number Called Length of Employment

ng Party Position of person that Verified Salary ? $ WK MO YR
re Paystubs? Yes No* Tax Return (s)? Yes No* New Employment 'Offer Letter" required? *
lyee Initials Date:

>us Employer Phone Number Called Length of Employment

ing Party Position of person that Verified Salary ? $ WK MO YR

re Paystubs? Yes No* Tax Return (s)? Yes No* New Employment "Offer Letter* required?

lyee Initials Date: fCopies must be attached and must be equal to or greater than rental amount)

xial Income Source Phone Number Called Length of employment

ng Party Proof of Additional Income Attached? (bank statement showing direct deposit, court order of child support.
ly or trust iund, copy of Sodal Security, Disability or Pension Statement, notarized letter of parental support. Tax returns or Investment
nents) Employee's Initials Date Comments ______^_
Credit References

CHECKING ACCT. BANK ADDRESS/BRANCH" PHONE * BRANCH # ACCT. »

* r
r-*

CREDFT REFERENCES ADDRESS •• TYPE ACCT. ACCT. #

CREDIT REFERENCES ADDRESS TYPE ACCT. ACCT. #

Personal References

M fc
NAME ADDRESS PHONES . RELATII

NAME ADDRESS PHONE* RELATIONSHIP

In Case of Emergency

1
NAME 'kDDRESS

Cr^l*\ 7 "7 7 -7.

RELATIONSHIP PHONES ~" ' ; f 11 "^
^

Automobiles

LICENSE # MAKE MODEL YEAR

LICENSE * MAKE MODEL YEAR

Other Vehicles:

PLEASE NOTE: EVERY ITEM MUST BE FILLED IN AND COMPLETED IN ITS ENTIRETY.
REVIEW YOUR APPLICATION BEFORE YOU TURN IT IN TO THE MANAGER.

THE APPUCANT REPRESENTS THAT THE ABOVE STATEMENTS. ARE TRUE AND CORRECT AND HEREBY AUTHORIZES
VERIFICATION OF INFORMATION CONCERNING SAID APPLICANT. IT IS UNDERSTOOD THE FEE OF $ IS
NOT A DEPOSIT AND WILL NOT RFEEFUMTBn IF APP1IPMJT IS DECLINED.

APPLICANT DATE
2. * '

APPLICANT DATE