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⚠️ Before you start: Complete all questions. If any question is left blank this application may not be processed. All information will be verified. This application is for a single person or a married couple only.

General Information

Property Address*

Apt. / Unit #

Date*

Primary Applicant

Full Name*

Date of Birth*

Social Security #*

Marital Status*

Single Married Separated Divorced

Maiden Name

Ever Convicted of a Crime?*

Date(s) of Conviction

County / State Convicted In

Charge(s)

Spouse / Co-Applicant

Leave blank if not applicable

Spouse Full Name

Date of Birth

Social Security #

Spouse Maiden Name

Spouse Ever Convicted?

Date(s) of Conviction

County / State Convicted In

Spouse Charge(s)

Occupants & Contact

No. of Adults (18+)*

Pets (description / breed / weight)

Names & Ages of All Others Occupying Unit

Cell Phone*

Email*

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact Address

Part I — Residence History

Please print full address including unit/apt number, city, state & ZIP code

A. Present Address

Full Address*

Apt / Condo Name

Phone

From

Type

Rent / Mortgage Amount

Landlord Name

Landlord Address

Landlord Phone

Mortgage Holder

Mortgage No.

Mortgage Holder Phone

B. Previous Address

Full Address

Apt / Condo Name

Phone

From

Type

Rent / Mortgage Amount

Landlord Name

Landlord Address

Landlord Phone

Part II — Employment References

Include a recent copy of an earnings statement to expedite processing

A. Applicant Employment

Employer Name*

Employer Phone

Fax

From

To (or Present)

Position / Title

Monthly Gross Income*

Employer Address

B. Spouse Employment

Employer Name

Employer Phone

Fax

From

To (or Present)

Position / Title

Monthly Gross Income

Employer Address

Part III — Bank References

Include a recent copy of a bank statement to expedite processing

A. Bank Name

Checking Account #

Phone

B. Bank Name

Savings Account #

Phone

Part IV — Character References

No family members · Please notify references that we will be contacting them

Reference 1

Full Name*

Home Phone

Business Phone

Address

Cell Phone

Reference 2

Full Name*

Home Phone

Business Phone

Address

Cell Phone

Driver's License & Vehicle

Primary Applicant DL #*

State Issued

Secondary Applicant DL #

State Issued

Vehicle Make

Type / Model

Year

License Plate #

📎 Required Supporting Documents After submitting this form, please email the following for each adult applicant to jorge@mpmc.co with your full name and unit address in the subject line:

Copy of Driver's License
Copy of Social Security Card
Proof of Income (pay stub or bank statement)

If this application is not legible or is not completely and accurately filled out, MAGANA PMC LLC will not be liable or responsible for any inaccurate information in the investigation and related report caused by such omissions or illegibility.

By signing below, the applicant recognizes that MAGANA PMC LLC will investigate the information supplied by the applicant, and a full disclosure of pertinent facts will be made. The investigation may include the applicant's character, general reputation, personal characteristics, credit standing, police arrest record and mode of living as applicable. This form is for the exclusive use of MAGANA PMC LLC.

Applicant Signature (type full name)*

Spouse Signature (type full name)

Date*

By submitting you confirm all information is accurate and authorize Magaña PMC LLC to verify.

✅ Application Submitted!

General Information

Primary Applicant

Spouse / Co-Applicant

Occupants & Contact

Part I — Residence History

Part II — Employment References

Part III — Bank References

Part IV — Character References

Driver's License & Vehicle