Buzz# to get into bldg.
Address
First, Middle, & Last Name
Delivery Address No. street apt#
(Spouse/Roomate)
First, Middle, & Last Name
City, Zip Code
Home Phone Number
How long at this address?
E-Mail Address/s
Employment Co. Name
Employment Address City St., Zip
Employment Phone No. & Ext.
How long at current job
Position/Title
Monthly Income
Drivers License No. & Exp. Date
Valid in what State
Car License Number & State
Make Model & Year
Age & Date of Birth
VISA Card Number
Exp. Date
MASTERCARD Number
Exp. Date
AMERICAN EXPRESS Number
Exp. Date
Spouse/Roomate Dvrs.Lic.& Exp..
State
Spouse/Roomate Employment Co.
Spouse/Roomate Emp't. Address
Employment. Phone No. & Ext.
Personal Reference Name
Phone Number
Name of Nearest Relative
Address
Phone Number
Rental Application
Serving the West Side of Southern California since 1983
California Appliance Refrigerator Rentals & Sales New & Used Major Appliances
I would like to rent
Apt. Mgr's. Name & Phone
Age & Date of Birth
Spouse/Roomate Age, Date of Birth
In Case of Refund, Give Mailing Address and Phone No.
where you can always be reached (other than new address).
(310) 838-1288
Notify me
How did you find us?
Click To Apply >
I/we certify that all statements made above are true and correct. I understand that any deliberate false statement may, at the option of the lessor/agent, result in immediate cancelation of rental, and will incurr a cancelation fee.
Please select 1 option from each box
