Bruce A. Duckett, Designated Broker
Duckett Management & Real Estate
Phone-602-578-7199
Fax-480-981-6493
duckettmgmtre@aol.com
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  Application
 
 
  Primary Applicant Information   
 
What Is The Property Address To Be Rented?   
 
Name   
 
Present Address / How Long?   
 
City   
 
State   
 
Zip Code   
 
Cell Phone   
 
Pets; Breed & Name of Pet   
 
Email *   
 
Date of Birth   
 
Social Security Number   
 
Drivers License Number & State   
 
How Did You Hear About Us? Newspaper, Online?   
 
  Employment Information   
 
Employers Name   
 
Employers Address   
 
Work Phone   
 
How long at present job?   
 
Gross Monthly Salary (US dollars)   
 
Other Monthly Income (US dollars)   
 
  Criminal History   
 
Has any Occupant Ever Been Convicted of ANY Crime?   
 
Number of Occupants to be in the Residence?   
 
Current Landlord or Property Manager Name & Phone Number   
 
Any Evictions in the Previous Three Years?   
 
  Joint Applicant Information   
 
Name   
 
Address   
 
City   
 
State   
 
Zip Code   
 
Cell Phone   
 
Social Security Number   
 
Joint Applicant; Drivers License Number & State   
 
Joint Applicant Birth Date   
 
Employers Name   
 
Employers Address   
 
Work Phone   
 
How long at present job?   
 
Gross Monthly Salary (US dollars)   
 
  Digital Signature   
 
By Digitally Signing Application; Applicant Authorizes Duckett Management to Verify ALL Information *   
 
Applicant A *   
 
Date *   
 
Applicant B   
 
Date   
 
 
 Verification
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duckettmgmtre@aol.com


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