Coburn & Feeley
 
 
 
Professional property management since 1978
 

346 Shelburne Rd.
Hickok & Boardman Place, Ground Floor
PO Box 4057
Burlington, VT 05406


Hire Coburn & Feeley to manage your property


Apartment Rentals in Burlington, VT


Properties for Rent in Burlington, VT


Maintenance Request

 
Fields marked * are required
Taft Farm Rental Application
Applicant Name:* 
Email:* 
Date of Birth:* 
Social Security Number:* 
Home Phone:* 
Mobile Phone: 
Driver`s License Number:* 
Co-Applicant Name: 
Co-Applicant Email: 
Co-Applicant DOB: 
Co-Applicant SSN: 
Co-Applicant home Phone#: 
Co-Applicant Mobile Phone: 
Co-Applicant Driver`s License: 
Co-Applicant`s Relationship to Applicant: 

OTHER OCCUPANTS
Name: 
Date of Birth: 
Relationship: 
Name: 
Date of Birth: 
Relationship: 
Name: 
Date of Birth: 
Relationship: 
Name: 
Date of Birth: 
Relationship: 

ADDITIONAL INFORMATION:
Your Present Street Address:* 
Your Present City, ST Zip:*
Dates From / To:*
Landlord Name:* 
Landlord Phone:* 
Monthly Rent $:* 
Reason for Leaving:*
Your Complete Previous Address:*
Dates From / To:* 
Previous Landlord Name:* 
Previous Landlord Phone:* 
Previously Monthly Rent:* 
Previous Reason for Leaving:*
Co-Applicant
Co-Applicant Address:
Co-Applicant Address Dates From / To: 
Co-Applicant Landlord Name: 
Co-Applicant Landlord Phone: 
Co-Applicant Monthly Rent: 
Co-Applicant Reason for Leaving Current Address:
Co-Applicant Previous Address: 
Co-Applicant Previous Dates From / To: 
Co-Applicant Landlord Name: 
Co-Applicant Landlord Phone: 
Co-Applicant Monthly Rent: 
Co-Applicant Reason for Leaving Previous Address:
Co-Applicant - Have you ever been evicted from any leased premises?
YesNo
If yes, explain:
MISCELLANEOUS
HAVE YOU OR YOUR SPOUSE EVER:
Been Served an Eviction Notice or Been Asked to Vacate the Property You Were Renting?*
YesNo
Been Evicted?*
YesNo
Broken or in Any Manner Failed to Honor Your Lease?*
YesNo
Filed Bankruptcy?*
YesNo
Been Convicted of a Felony?*
YesNo
Do You Pay Child Support or Alimony?*
YesNo
If You Answered Yes to any of the Above Questions, Please Explain:
Do you / Co-Applicant have any pets?*
YesNo
Do you/Co-Applicant/household members recieive Section 8 Rental Assistance?*
YesNo
If Yes, please select:

EMPLOYMENT / INCOME
Applicant Present Employer:* 
Applicant Position:* 
Applicant Business Address:*
Applicant Business Phone:* 
Applicant Supervisor:* 
Applicant Employed Since:* 
Applicant Gross Mo. Salary:* 
Applicant Additional Mo. Income (if any) / Source $:
Co-Applicant
Co-Applicant Present Employer: 
Co-Applicant Postition: 
Co-Applicant Business Address:
Co-Applicant Business Address:
Co-Applicant Business Phone: 
Co-Applicant Supervisor: 
Co-Applicant Employed Since: 
Co-Applicant Gross Monthly Salary: 
Co-Applicant Additional Mo. Income (if any) / Source $:
EMERGENCY
Name and Address of Nearest Relative NOT Living with You:*
Relationship:* 
Home and Work Phones:*
Co-APPLICANT
Co-Applicant Name and Address of Nearest Relative NOT Living with You:
Co-Applicant Emergency Contact Relationship: 
Co-Applicant Emergency Home and Work phones:
In the event of serious illness or death of resident, the above Co-Applicant Emergency Contact is Authorized to Enter the Apartment and Remove all contents:*
Yes, Co-Applicant contact is Authorized
No, Co-Applicant Emergency contact is Not Authorized
Applicant represents that all the above statements are true and complete, and hereby authorizes verification of the above information. Verification shall include, but not limited to the procurement of a personal credit history. Credit history will be used to qualify the applicants, for periodic account review purposes, as well as to collect outstanding debt at termination, if necessary.
All Applicants acknowledge that false information herein may constitute grounds for rejection of this application, termination of occupancy, and may constitute criminal offense under the laws of this state. By clicking on the Submit button, I, the Applicant, have read and agree to all provisions of this application.*
Yes, Agreed.
No, Not Agreed.
Message or Comments:
Access Code
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