Homepage:  www.ruthtoal.com/apartment    Email:  ruthtoal@eircom.net

Bedroom Community to JERUSALEM:  Givat Sharet, Beit Shemesh
Adorable 2-Bedroom Partially-Furnished Apartment + Garden + Private Courtyard


Rental Application

Rental Terms / Contract   |   Estimated Utility Bills   |   Photos   |   Neighborhood Info


Tenant's Family Name: ________________________    First Name: ______________ Middle: ____

Previous Last Name: __________________________    First Name: ______________ Middle: ____

Date of Birth: month _________  day ___  year ____  Birthplace: city __________   state _________

ATTACH *SEPARATE APPLICATIONS* FOR EACH ROOMMATE and/or YOUR SPOUSE:

Spouse's Family Name: ________________________    First Name: ______________ Middle: ____

Children - Name: _____________________  Age: _____   Name: ____________________ Age: ____


Tenant's Email Address(es): _________________________________________________________

Tenant's Website Address: __________________________________________________________

Tenant's Country of Origin: __________________________    SSN No. ______________________

Tenant's Passport (attach xerox copy) No._______________________   Expiration: ________________

Tenant's Driver's License (attach xerox copy) No.__________________   Expiration: _______________

Tenant's Israeli ID / Teudat Za'hut (attach xerox copy) No.___________________________________

Tenant's Israeli Driver's License (attach xerox copy) No.___________________   Expiration: _______

Vehicle - Make: _____________  Model: _________  Year: _____  License Plate No.: ____________ 

Where will vehicle be kept? _____________________________________________________________


CURRENT Address (full mailing address) - Street: _______________________________________

City: _______________  State/County: ______________ Postal/Zip Code: ________  Country: ______

Dates of occupancy: __________________   Monthly Rent: ________   Landlord: _________________

Landlord Address (full mailing address) - Street: ____________________________________________

City: _______________  State/County: ___________ Postal/Zip Code: ________  Phone: ____________


PREVIOUS Address (full mailing address) - Street: _______________________________________

City: _______________  State/County: ______________ Postal/Zip Code: ________  Country: ______

Dates of occupancy: __________________   Monthly Rent: ________   Landlord: _________________

Landlord Address (full mailing address) - Street: ____________________________________________

City: _______________  State/County: ___________ Postal/Zip Code: ________  Phone: ____________


HOME ADDRESS ABROAD (for mailing) - Street: _______________________________________

City: _______________  State/County: ______________ Postal/Zip Code: ________  Country: _______

Home Phone Abroad:  ____________________________   Fax: ______________________________

Do you rent ___  or own ___?  Monthly Payment: ________   Dates of occupancy: _________________

Landlord Name: ____________________   Street: __________________________________________

City: _______________  State/County: ___________ Postal/Zip Code: ________  Phone: ____________



Guardian/Co-signer's Last Name: ___________________   First Name: _____________ Middle: ___

Guardian/Co-signer's Full Mailing Address - Street: __________________________________________

City: _______________  State/County: ___________ Postal/Zip Code: ________  Country: __________

Guardian/Co-signer's Phone:  __________________________   Fax: ____________________________



Employer: ________________________________  Employer Phone: _______________________

Employer's Email: _________________________________________________________________

Employer's Website Address: ________________________________________________________

Full Work Address - Street: _________________________________________________________

City: _______________  State/County: ___________ Postal/Zip Code: ________  Country: _________

Position: _________________________________________   Date of Hire: _____________________

Monthly Net Salary: _________________________________________________________________

Supervisor's Name: _________________________________   Phone: _______________________


Other Sources of Income: ___________________________________________________________

KINDLY DO NOT USE EMPLOYER AS ONE OF THE FOUR (4) REFERENCES BELOW:

Reference #1 - Family Name: __________________    First Name: ________________ Middle: ___

Occupation: _______________    Phone: _________________  Email Address: __________________

Relation to Tenant: _________________________________________________________________

Mailing Address: _________________________________________________________________

Reference #2 - Family Name: __________________    First Name: ________________ Middle: ___

Occupation: _______________    Phone: _________________  Email Address: __________________

Relation to Tenant: _________________________________________________________________

Mailing Address: _________________________________________________________________

ALL APPLICANTS MUST PROVIDE TWO (2) NON-FAMILY CHARACTER REFERENCES AND TWO (2) FINANCIAL REFERENCES. KINDLY PRINT THE REMAINING TWO REFERENCES ON A SEPARATE SHEET AND ATTACH TO THIS APPLICATION.
Thank you for your cooperation.
Incomplete or illegible applications will be returned to sender for resubmission.


Have you ever been evicted? ______        Have you ever been convicted of a crime? ______

Do you smoke? _________

In case of emergency notify: _____________________________    Phone: ______________________

I declare that the statements above are true and correct.
I authorize verification of my rental history, references, guardians,
employment and background as they relate to my tenancy AND to future rent collections.
I understand that prior approval and written permission must be received from the landlord
before animals/pets can be kept in the apartment or in the garden or courtyard.

Signature: ______________________________________________ Date: _____________________

Print Full Name in all CAPS:  _________________________________________________________

Send the following:
(1) Completed Rental Application(s) - one for each tenant
(2) Clear copies of Passports (both Israeli and Country-of-Origin) - for each tenant
(3) Clear copies of Driver's licenses - for each tenant
(4) Clear copies of Israeli I.D./T.Z. - for each tenant
(5) Last THREE (3) Pay Stubs - for each tenant
(6) The contact details (phone and mailing address) of Two Character References
(non family)
(7) The contact details (phone and mailing address) of Two Financial References
(non family)

TO:  PAUL & RUTH TOAL, ALTIQUIN, Drumkeerin, Co. Leitrim, Ireland.
FAX: 1-775-535-3382


This site was designed in full and is maintained by: Ruth Toal, designer of  www.ruthtoal.com


Verified By _______:

SSN___  Passport___  DL___  T.Z.___  IDL___  CurTen___  Prev___  Emp___  G/CoS___  Ref#1___  Ref#2___


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