Online Application |Pearsey's Rentals

Please fill out all fields before attempting to submit this form.

Name *

Cell Phone *

Home Phone *

Email *

Home Address 1 *

Home Address 2

City *

State *

Zip Code *

Products you are interested in *

Date of Birth *

Social Security Number *

Drivers License or State ID Number *

Drivers License / ID Issued State *

Length of Time at Current Address *

Previous Address *

Landlord Contact Details *

Previous Landlord Contact Details *

Vehicle Details

Ever Rented-to-Own Before? *

We ask for 6 references to apply for credit with our store.

Reference 1 (Relative) *

Reference 2 (Relative) *

Reference 3 (Relative) *

Reference 4 (Friend) *

Reference 5 (Friend) *

Reference 6 (Friend) *

Instructions

Please scan and submit the follwing items for verification:

Uploaded Files

Thank You

Pearsey's Rentals Bakersfield