Please take a moment to fill out the rental application and we will get in touch with you regarding approval.

All fields are required. If one does not apply to your situation, please enter “n/a”. Call us at 252.412.2771 if you have any questions.

Thank you for choosing Pagliari Properties.

- Kevin and Leslie Pagliari

Pagliari Properties Rental ApplicationĀ 





Your Name (required)

Your Email (required)

Date of Birth (required)

Social Security Number (required)

Current Address (required)

City, State (required)

Phone (required)

Cell Phone (required)

Date you moved to this address (required)

Amount of rent/mortgage (required)

Reason for leaving (required)

Current employer (required)

Date employed (required)

Supervisor (required)

Occupation (required)

Monthly salary (required)

Employer phone (required)

Co-Applicant’s Name (required)

Co-Applicant’s Date of Birth (required)

Co-Applicant’s SSN (required)

Current Address (required)

City, State (required)

Phone (required)

Cell Phone (required)

Co-applicant Email (required)

Date you moved to this address (required)

Amount of rent/mortgage (required)

Reason for leaving (required)

Current employer (required)

Date employed (required)

Supervisor (required)

Occupation (required)

Monthly salary (required)

Employer phone (required)

Names, ages and relationships of those to occupy rental other than Applicant or Co-Applicant

Have you ever filed bankruptcy? (required)
 yes no

Have you ever been convicted of a felony? (required)
 yes no

Been sued for nonpayment of rent or damages? (required)
 yes no

Broken a rental contract or lease agreement? (required)
 yes no

Been evicted? (required)
 yes no

If yes to any answers above, please give details

Please review the information that you have provided and read the following:

I/We warrant that all statements above set forth are true and correct, and I/We have a good credit report worthy of Pagliari Properties to risk in approving this application. I/We authorize verification of above information and grant Pagliari Properties permission to conduct a credit investigation on the Applicant and/or Co-Applicant in processing this application for approval. I/We acknowledge that discovery by Pagliari Properties of false information herein, or determination solely in the opinion of Pagliari Properties of a credit record unworthy of Pagliari Properties risk, may constitute grounds for rejection of this application and forfeiture of deposits, and may constitute a criminal offense under the laws of this State.

If you agree with the information above, please initial below:

Applicant’s initials (required)

Co-Applicant’s initials (required)

Date (required)

Number you can be reached (required)

Please enter the letters or numbers below (required)
captcha

Thank you! Please click the “submit” button below. We will process and contact you soon.