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Rental application

Apply to rent with Cooper & Associates

This is your real rental application, fillable right on the page. Click into any blank line and type — everything else is part of the original document and can't be changed. Nothing is submitted online or saved anywhere; when you're done, click Print / Save as PDF below to get your completed application, then bring, email, or fax it to our office along with the required documents.
Application Checklist — please bring these with you:

327 South Grace Street, Rocky Mount, NC 27804 · Office (252) 977-1429 · Fax (252) 454-0799

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COOPER & ASSOCIATES REAL ESTATE SERVICES, INC.
Property Management Division
Rental Application Policies

Application Fee: A non-refundable application fee of $55.00 per adult applicant is required at the time of application. This fee covers the cost of background and credit screening.

Criminal Report Add-On: An additional $20.00 fee applies if a criminal background report is requested separately. This is collected at the time of application.

Identification: All applicants must provide a valid, government-issued photo ID (driver's license, state ID, or passport). A copy will be retained on file.

Employment Verification: Applicants must provide proof of continuous employment for a minimum of six (6) months. Acceptable documentation includes recent pay stubs, an offer letter for new employment, or a letter from your employer on company letterhead.

Income Requirement: Gross monthly household income must equal or exceed three (3) times the monthly rent. Documentation such as recent pay stubs (last 30 days), bank statements (last 60 days), or tax returns may be required to verify income.

References: Applicants must supply private personal references only — references from family members or current/former employers will not be accepted. A minimum of two (2) verifiable references are required.

Credit and Background Check: A full credit and background check will be performed on all adult applicants. Negative credit history, prior evictions, or a criminal record may result in denial of the application.

Fair Housing Statement: Cooper & Associates Real Estate Services, Inc. is an equal opportunity housing provider. We comply fully with all applicable fair housing laws and do not discriminate on the basis of race, color, national origin, religion, sex, familial status, disability, or any other protected class.

Agent Conduct: All agents of Cooper & Associates conduct themselves in a professional and ethical manner at all times. Any concerns regarding agent conduct should be directed to the office manager.

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COOPER & ASSOCIATES REAL ESTATE SERVICES, INC.
Property Management Division
Authorization for Credit and Background Check

I/We hereby authorize Cooper & Associates Real Estate Services, Inc. and its designated agents, representatives, and affiliates to obtain and review my/our credit report, criminal background history, rental history, and any other relevant personal information from consumer reporting agencies or other lawful sources. This authorization is given for the purpose of evaluating my/our rental application and my/our suitability as a tenant.

I/We understand and agree that:

  • ★ This authorization remains valid for the duration of the tenancy and any renewals thereof, as permitted by applicable law.
  • ★ The information obtained may be used to make decisions regarding my/our application, lease renewals, or continued tenancy.
  • ★ I/We have the right to request a copy of any consumer report used in an adverse action and to dispute inaccurate information with the relevant reporting agency.

By signing below, I/we confirm that all information provided in this rental application is true and complete to the best of my/our knowledge. I/We understand that providing false or misleading information is grounds for immediate denial or termination of tenancy.

Applicant Signature
Date
Co-Applicant Signature (if applicable)
Date
COOPER & ASSOCIATES REAL ESTATE SERVICES, INC.
Property Management Division
Please Be Aware

Money Orders Only: All payments — including the application fee, security deposit, and monthly rent — must be submitted in the form of two (2) separate money orders. Personal checks, cash, and electronic transfers are not accepted unless otherwise specified in writing by the office.

Pet Policy: Tenants with pets are required to pay a $250 pet deposit plus an additional $25.00 per month, per animal. All pets must be approved in writing prior to move-in. Unauthorized pets are a lease violation.

Liability Insurance: All tenants are required to carry renters/liability insurance with a minimum coverage amount of $30,000. Proof of coverage must be provided to the office prior to receiving keys and must remain active for the duration of the lease.

Utility Setup: Tenants must provide proof of utility account setup in their name before keys will be released. This includes electricity, water/sewer, and any other applicable utilities. Keys will not be issued until all required utility confirmations are received.

COOPER & ASSOCIATES REAL ESTATE SERVICES, INC.
EFFECTIVE IMMEDIATELY

THERE WILL BE NO LEASE SIGNING
WITHOUT AN APPOINTMENT.

ONCE YOU ARE APPROVED AND YOU PAY YOUR DEPOSIT(S) YOU WILL BE SCHEDULED TO COME BACK TO THE OFFICE TO SIGN YOUR LEASE.

NO EXCEPTIONS WILL BE MADE