Ross Pacific
Online Rental Application

This application will take about 5-10 minutes to complete and uses a secure encrypted connection to ensure your privacy.

In the event of co-tenants other than spouse, each individual 18 or older must complete a separate application.

Ross Pacific Online Rental Application

Property address applying for

Address, Street, City

Best phone number to reach you

Email Address

Desired move in date

Page 1 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Applicant

Last Name
First Name
Middle Name
Birthdate

Driver's License # and State

Social Security Number

Spouse

Last Name
First Name
Middle Name
Birthdate

Driver's License # and State

Social Security Number

Page 2 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Name and ages of other occupants

Do you have animals/pets?

What breed of pets

Do you have a waterbed

Do you have waterbed insurance?

Page 3 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Current residence

Street Address, City, State, Zip

Move in date

Month/Year

Currently

 

Monthly payment

Phone number

Name of current

Name or company name

Daytime phone of landlord or other

Nighttime phone of landlord or other

Why are you leaving your current residence

Page 4 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Previous applicant's residence

Street Address, City, State, Zip

Move in date

Month/Year

Move out date

Month/Year

 

 

Monthly payment

Phone number

Name of previous

Name or company name

Daytime phone of landlord or other

Nighttime phone of landlord or other

Why did you leave your previous residence

Page 5 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Previous spouse's residence

Street Address, City, State, Zip

Move in date

Month/Year

Move out date

Month/Year

 

 

Monthly payment

Phone number

Name of previous

Name or company name

Daytime phone of landlord or other

Nighttime phone of landlord or other

Why did you leave your previous residence

Page 6 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Applicant employed by

Company name

Supervisor's name and C.O.

 

Company address

Street Address, City , State, Zip

Position held

 

Phone number

 

Hire date

Month/Year

Salary

 

 

 

Spouse employed by

Company name

Supervisor's name and C.O.

 

Company address

Street Address, City , State, Zip

Position held

 

Phone number

 

Hire date

Month/Year

Salary

 

 

 

Page 7 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Applicant previously employed by

Company name

Supervisor's name and C.O.

 

Company address

Street Address, City , State, Zip

Position held

 

Phone number

 

Hire date

Month/Year

Salary

 

 

 

Spouse previously employed by

Company name

Supervisor's name and C.O.

 

Company address

Street Address, City , State, Zip

Position held

 

Phone number

 

Hire date

Month/Year

Salary

 

 

 

Page 8 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Additional source of income #1

 

Amount

 

Frequency

Weekly, Monthly, Yearly

Additional source of income #2

 

Amount

 

Frequency

Weekly, Monthly, Yearly

Automobile #1

Make and model

License plate

 

State

 

Monthly payment

 

Automobile #2

Make and model

License plate

 

State

 

Monthly payment

 

Bank or Credit Union

Branch

Checking account #

Savings account #

Page 9 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Applicant's Nearest Relative

Name

Relationship

 

Address

Street Address, City, State Zip

Phone number

 

Spouse's Nearest Relative

Name

Relationship

 

Address

Street Address, City, State Zip

Phone number

 

Emergency contact

Name

Relationship

 

Address

Street Address, City, State Zip

Phone number

 

Reference

Name

Relationship

 

Address

Street Address, City, State Zip

Phone number

 

Page 10 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Have you or your spouse ever filed for bankruptcy

Applicant
Spouse

Bankrupty date

Describe bankruptcy circumstances


Bankrupty date

Describe spouse bankruptcy circumstances

Has an eviction ever been filed against you?

Applicant
Spouse

State/County

Describe eviction circumstances


State/County

Describe spouse eviction circumstances

Have you ever pleaded guilty to, been convicted of, or have pending against you a criminal charge?

Applicant
Spouse

State/County

Describe criminal history


State/County

Describe spouse criminal history

In compliance with state and federal laws, this is to inform you that an investigation involving the statements made regarding your rental application with this landlord is being initiated. You have the right to dispute the information reported. Direct inquiries to Bemrose Consulting. All or part of the information submitted on this form may be made available to other services unless this box is checked.
I certify that to the best of my knowledge all statements are true and complete. I further authorize Bemrose Consulting to obtain credit reports, character reports, verification of rental, employment, and criminal history as necessary to verify all information put forth in this application process. False, fraudulent, or misleading information may be grounds for denial of tenancy or subsequent eviction.
I have read and understand Ross Pacific's Rental Criteria

Page 11 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647

Ross Pacific Online Rental Application

Automatic Withdrawal for Application Fee

Ross Pacific Management charges the following fees to run our rental application.
$47.00 per adult application, $47.00 per additional adult applicant and $47.00 per cosigner.
Please note that we must have the application fee before starting the application screening process

Adult Applicant(s) $47 each Additional Adult(s) $47 each Co-Signer(s) $47 each
Total Fees to be withdrawn:
Ross Pacific Management will contact you to make payment arrangements once we receive your application. The application fee will be charged upon submission to our screening company, Bemrose Consulting.

Page 12 of 12

Application for Ross Pacific Management
8513 NE Hazel Dell Avenue, Ste. 101,
Vancouver, Washington 98665
(360) 574-7647