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Renter Information

Renters First Name *

Renters Last Name *

Cell Phone *

Email Address *

Street Address *

City *

State *

Zip *

Renter Employer/Income

Renters Employer/Source of Income

Address

Phone

Supervisor Name

Co-Renter Information

Co-Renters First Name

Co-Renters Last Name

Personal References

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *

RELEASE OF INFORMATION TO Affordable Home Furnishings: (PLEASE READ BEFORE SIGNING)

The Information I(we) have provided on this form is correct. I authorize confirmation of all information that I(we) have provided. Affordable Home Furnishings may contact any person or company that is lis

FOR RENTER
I am applying for rental, and am over 18 years of age.

FOR CO-RENTER
I am applying for rental, and am over 18 years of age.

Please Respond to the Following Question and Prove You're A Human

Disclaimer: *TBD on a new agreement through 11/30/24 when you bring in this card. Regular agreement rates resume 12/01/24. Limit one per customer. Not applicable with any other offers. Not valid on gaming consoles. Further restrictions may apply. Product availability varies by store. See store for details. ©2024 Affordable Home Furnishings