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Rental Information



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First Name:
Last Name:
Email:
Phone Number:
Current Address:
How long at this address:  
Previous Address:
How long at this address:  
Current Employer:  
Employment Length:  
Gross Monthly Income:  
Previous Employer:  
Employment Length:  
Gross Monthly Income:  
Do you have the following on your record
(does not automatically disqualify you if you do)
Eviction:
Foreclosure:
Bankruptcy:
What are you looking for:
Style:
Location:
Bedrooms:
Bathrooms:
Garage:
Basement:
Monthly Payment You Can Afford:  
Security deposit you can afford:  
Additional Info:
 
   

Integrity Home Buyers, Inc.

Kevin Derr
(937) 605-6868

Donna Pena
(937) 390-0816

 
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