" . "\r\n"; //$header .= "MIME-Version: 1.0\r\n"; //$header .= "Content-Type: text/html; charset=ISO-8859-1\r\n"; $emailbody = " [Property:] $property\n\n[Name:] $thename\n[SSN:] $ssn\n[License #:] $dl\n[Birthday:] $dob\n[Cell Phone:] $cellphone\n[Home Phone:] $homephone\n[Email:] $email\n ***** OTHER OCCUPANTS *****\n [Other Occupant #1 Name:] $occname1\n[Other Occupant #1 Age:] $occage1\n [Other Occupant #2 Name:] $occname2\n[Other Occupant #2 Age:] $occage2\n [Other Occupant #3 Name:] $occname3\n[Other Occupant #3 Age:] $occage3\n [Other Occupant #4 Name:] $occname4\n[Other Occupant #4 Age:] $occage4\n ***** PETS *****\n [Pets:] $pets\n[Pet Description:] $petdesc\n ***** AUTOMOBILES *****\n [Auto #1 Year:] $caryear1\n[Auto #1 Make:] $carmake1\n[Auto #1 Model:] $carmodel1\n[Auto #1 Color:] $carcolor1\n[Auto #1 State:] $carstate1\n[Auto #1 Plate:] $carplate1\n [Auto #2 Year:] $caryear2\n[Auto #2 Make:] $carmake2\n[Auto #2 Model:] $carmodel2\n[Auto #2 Color:] $carcolor2\n[Auto #2 State:] $carstate2\n[Auto #2 Plate:] $carplate2\n [Auto #3 Year:] $caryear3\n[Auto #3 Make:] $carmake3\n[Auto #3 Model:] $carmodel3\n[Auto #3 Color:] $carcolor3\n[Auto #3 State:] $carstate3\n[Auto #3 Plate:] $carplate3\n ***** CURRENT RESIDENCE *****\n [Current Address:] $currentaddress\n[Current Landlord:] $currentlandlord\n[Current Landlord Phone:] $currentlandlordphone\n[Current Payment:] $currentpayment\n[Reason for Leaving:] $currentreason\n ***** PREVIOUS RESIDENCE #1 *****\n [Previous Address:] $previousaddress1\n[Previous #1 Landlord] $previouslandlord1\n[Previous #1 Landlord Phone:] $previouslandlordphone1\n[Previous #1 Payment:] $previouspayment1\n[Reason for Leaving:] $previousreason1\n[Date Range:] $firstpreviousdate1 - $secondpreviousdate1\n ***** PREVIOUS RESIDENCE #2 *****\n [Previous 2 Address:] $previousaddress2\n[Previous #2 Landlord] $previouslandlord2\n[Previous #2 Landlord Phone:] $previouslandlordphone2\n[Previous #2 Payment:] $previouspayment2\n[Reason for Leaving:] $previousreason2\n[Date Range:] $firstpreviousdate2 - $secondpreviousdate2\n ***** INCOME STATEMENT *****\n [Gross Income:] $income\n[Income Source:] $incomesource\n ***** CURRENT EMPLOYER *****\n [Current Employer:] $currentemployername\n[Current Employer Title:] $currentemployertitle\n[Current Employer Started:] $currentemployerstartdate\n[Current Employer Address:] $currentemployeraddress\n[Current Employer Supervisor:] $currentemployersupervisor\n[Current Employer Supervisor Phone:] $currentemployerphone\n ***** PREVIOUS EMPLOYER #1 *****\n [Previous Employer #1:] $previousemployername1\n[Previous Employer #1 Title:] $previousemployertitle1\n[Previous Employer #1 Started:] $previousemployerstartdate1\n[Previous Employer #1 Address:] $previousemployeraddress1\n[Previous Employer #1 Supervisor:] $previousemployersupervisor1\n[Previous Employer #1 Supervisor Phone:] $previousemployerphone1\n[Previous Employer #1 Reason Left:] $previousreason1\n ***** PREVIOUS EMPLOYER #2 *****\n [Previous Employer #2:] $previousemployername2\n[Previous Employer #2 Title:] $previousemployertitle2\n[Previous Employer #2 Started:] $previousemployerstartdate2\n[Previous Employer #2 Address:] $previousemployeraddress2\n[Previous Employer #2 Supervisor:] $previousemployersupervisor2\n[Previous Employer #2 Supervisor Phone:] $previousemployerphone2\n[Previous Employer #2 Reason Left:] $previousreason2\n ***** QUESTIONNAIRE *****\n [Smoker?] $smoke\n[Explain:] $smokeexplain\n [Water Furniture?] $waterfurniture\n[Explain:] $waterfurnitureexplain\n [Eviction Record?] $evictionrecord\n[Explain:] $evictionrecordexplain\n [Criminal Record?] $criminalrecord\n[Explain:] $criminalrecordexplain\n [Bankruptcy?] $bankruptcy\n[Explain:] $bankruptcyexplain\n ***** REFERENCE #1 *****\n [Reference #1 Name:] $referencename1\n[Reference #1 Relationship:] $referencerelationship1\n[Reference #1 Address:] $referenceaddress1\n[Reference #1 Phone:] $referencephone1\n[Reference #1 Known:] $referenceknown1\n ***** REFERENCE #2 *****\n [Reference #2 Name:] $referencename2\n[Reference #2 Relationship:] $referencerelationship2\n[Reference #2 Address:] $referenceaddress2\n[Reference #2 Phone:] $referencephone2\n[Reference #2 Known:] $referenceknown2\n ***** EMERGENCY CONTACT *****\n [Emergency Contact Name:] $emergencyname\n[Emergency Contact Relationship:] $emergencyrelationship\n[Emergency Contact Address:] $emergencyaddress\n[Emergency Contact Phone:] $emergencyphone\n [E-Signature:] $signature\n [Timestamp:] $date\n\n [Originator Information:] $location\n "; if(mail($to, $subject, $emailbody, $header)) $success = "Transmission Successful!"; else $error = "Unexpected problem. Please call 417-343-0941."; } echo ' New Tenant Application Submitted '.$headernav.'

Request Submitted

'.$success.' You sent the following message to support@mostateproperties.com
[Property:] '.$property.'

[Name:] '.$thename.'
[SSN:] '.$ssn.'
[License #:] '.$dl.'
[Birthday:] '.$dob.'
[Cell Phone:] '.$cellphone.'
[Home Phone:] '.$homephone.'
[Email:] '.$email.'

***** OTHER OCCUPANTS *****

[Other Occupant #1 Name:] '.$occname1.'
[Other Occupant #1 Age:] '.$occage1.'

[Other Occupant #2 Name:] '.$occname2.'
[Other Occupant #2 Age:] '.$occage2.'

[Other Occupant #3 Name:] '.$occname3.'
[Other Occupant #3 Age:] '.$occage3.'

[Other Occupant #4 Name:] '.$occname4.'
[Other Occupant #4 Age:] '.$occage4.'

***** PETS *****

[Pets:] '.$pets.'
[Pet Description:] '.$petdesc.'

***** AUTOMOBILES *****

[Auto #1 Year:] '.$caryear1.'
[Auto #1 Make:] '.$carmake1.'
[Auto #1 Model:] '.$carmodel1.'
[Auto #1 Color:] '.$carcolor1.'
[Auto #1 State:] '.$carstate1.'
[Auto #1 Plate:] '.$carplate1.'

[Auto #2 Year:] '.$caryear2.'
[Auto #2 Make:] '.$carmake2.'
[Auto #2 Model:] '.$carmodel2.'
[Auto #2 Color:] '.$carcolor2.'
[Auto #2 State:] '.$carstate2.'
[Auto #2 Plate:] '.$carplate2.'

[Auto #3 Year:] '.$caryear3.'
[Auto #3 Make:] '.$carmake3.'
[Auto #3 Model:] '.$carmodel3.'
[Auto #3 Color:] '.$carcolor3.'
[Auto #3 State:] '.$carstate3.'
[Auto #3 Plate:] '.$carplate3.'

***** CURRENT RESIDENCE *****

[Current Address:] '.$currentaddress.'
[Current Landlord:] '.$currentlandlord.'
[Current Landlord Phone:] '.$currentlandlordphone.'
[Current Payment:] '.$currentpayment.'
[Reason for Leaving:] '.$currentreason.'

***** PREVIOUS RESIDENCE #1 *****

[Previous Address:] '.$previousaddress1.'
[Previous #1 Landlord] '.$previouslandlord1.'
[Previous #1 Landlord Phone:] '.$previouslandlordphone1.'
[Previous #1 Payment:] '.$previouspayment1.'
[Reason for Leaving:] '.$previousreason1.'
[Date Range:] '.$firstpreviousdate1.' - '.$secondpreviousdate1.'

***** PREVIOUS RESIDENCE #2 *****

[Previous 2 Address:] '.$previousaddress2.'
[Previous #2 Landlord] '.$previouslandlord2.'
[Previous #2 Landlord Phone:] '.$previouslandlordphone2.'
[Previous #2 Payment:] '.$previouspayment2.'
[Reason for Leaving:] '.$previousreason2.'
[Date Range:] '.$firstpreviousdate2.' - '.$secondpreviousdate2.'

***** INCOME STATEMENT *****

[Gross Income:] '.$income.'
[Income Source:] '.$incomesource.'

***** CURRENT EMPLOYER *****

[Current Employer:] '.$currentemployername.'
[Current Employer Title:] '.$currentemployertitle.'
[Current Employer Started:] '.$currentemployerstartdate.'
[Current Employer Address:] '.$currentemployeraddress.'
[Current Employer Supervisor:] '.$currentemployersupervisor.'
[Current Employer Supervisor Phone:] '.$currentemployerphone.'

***** PREVIOUS EMPLOYER #1 *****

[Previous Employer #1:] '.$previousemployername1.'
[Previous Employer #1 Title:] '.$previousemployertitle1.'
[Previous Employer #1 Started:] '.$previousemployerstartdate1.'
[Previous Employer #1 Address:] '.$previousemployeraddress1.'
[Previous Employer #1 Supervisor:] '.$previousemployersupervisor1.'
[Previous Employer #1 Supervisor Phone:] '.$previousemployerphone1.'
[Previous Employer #1 Reason Left:] '.$previousreason1.'

***** PREVIOUS EMPLOYER #2 *****

[Previous Employer #2:] '.$previousemployername2.'
[Previous Employer #2 Title:] '.$previousemployertitle2.'
[Previous Employer #2 Started:] '.$previousemployerstartdate2.'
[Previous Employer #2 Address:] '.$previousemployeraddress2.'
[Previous Employer #2 Supervisor:] '.$previousemployersupervisor2.'
[Previous Employer #2 Supervisor Phone:] '.$previousemployerphone2.'
[Previous Employer #2 Reason Left:] '.$previousreason2.'

***** QUESTIONNAIRE *****

[Smoker?] '.$smoke.'
[Explain:] '.$smokeexplain.'

[Water Furniture?] '.$waterfurniture.'
[Explain:] '.$waterfurnitureexplain.'

[Eviction Record?] '.$evictionrecord.'
[Explain:] '.$evictionrecordexplain.'

[Criminal Record?] '.$criminalrecord.'
[Explain:] '.$criminalrecordexplain.'

[Bankruptcy?] '.$bankruptcy.'
[Explain:] '.$bankruptcyexplain.'

***** REFERENCE #1 *****

[Reference #1 Name:] '.$referencename1.'
[Reference #1 Relationship:] '.$referencerelationship1.'
[Reference #1 Address:] '.$referenceaddress1.'
[Reference #1 Phone:] '.$referencephone1.'
[Reference #1 Known:] '.$referenceknown1.'

***** REFERENCE #2 *****

[Reference #2 Name:] '.$referencename2.'
[Reference #2 Relationship:] '.$referencerelationship2.'
[Reference #2 Address:] '.$referenceaddress2.'
[Reference #2 Phone:] '.$referencephone2.'
[Reference #2 Known:] '.$referenceknown2.'

***** EMERGENCY CONTACT *****

[Emergency Contact Name:] '.$emergencyname.'
[Emergency Contact Relationship:] '.$emergencyrelationship.'
[Emergency Contact Address:] '.$emergencyaddress.'
[Emergency Contact Phone:] '.$emergencyphone.'

[E-Signature:] '.$signature.'
[Timestamp:] '.$date.'

PROPERTIES

PAY MY RENT

MAINTENANCE



'.$footer.' '; } else { $getid = preg_replace("/[^0-9]/", "", $_GET["id"]); $servername = "localhost"; $username = "mostate_sql"; $password = "MSPsql&*@$"; $dbname = "mostate_data"; // Create connection $conn = new mysqli($servername, $username, $password, $dbname); // Check connection if ($conn->connect_error) { die("Connection failed: " . $conn->connect_error); } $sql = "Select `id`, `address` FROM `properties`"; $result = $conn->query($sql); $conn->close(); $jqmask1 = "jQuery(function($) { $.mask.definitions['~']='[+-]'; $('#homephone1, #cellphone1, #landlordphone, #previouslandlordphone1, #previouslandlordphone2, #employerphone, #employerphone2, #employerphone3, #employersupervisorphone, #previoussupervisorphone1, #previoussupervisorphone2').mask('(999) 999-9999'); })"; $jqmask2 = "jQuery(function($) { $.mask.definitions['~']='[+-]'; $('#date').mask('99/99/99'); })"; $jqmask3 = "jQuery(function($) { $.mask.definitions['~']='[+-]'; $('#ssn').mask('999-99-9999'); })"; $jqmask4 = "jQuery(function($) { $.mask.definitions['~']='[+-]'; $('#1stdaterange1, #1stdaterange2, #2nddaterange1, #2nddaterange2, #employerstartdate, #employerstartdate1, #employerstartdate2, #previousemployerstartdate1, #previousemployerstartdate2').mask('99/99'); })"; echo ' MoStateProperties New Tenant Application '.$headernav.'

New Tenant Application


Documents Required:
• Copy of Photo ID
• Proof of Income (3 most recent paystubs).

Send To: support@mostateproperties.com
Download This Form as a PDF

Property You Wish to Reserve:
Applicant Information
Tell us about yourself. All fields required.
Full Name:

SSN:

Driver\'s License #:

Date of Birth:

Cell Phone:

Home Phone:

Email:


Additional Occupants
If you will be living alone, leave this section blank.
Name:  Age:
Name:  Age:
Name:  Age:
Name:  Age:

Pets / Animals
Tell us about your pets, if you have any (required).
Will You Have a Pet(s)?

Description: (#, age, weight, breed, type, etc)


Occupant Vehicle(s)
For your safety and security please list all vehicles owned by people who will live here. If there are no vehicles, leave this section blank.
  🚗 Vehicle 1
Year:Make:
Model:Color:
State:Plate#:
  🚗 Vehicle 2
Year:Make:
Model:Color:
State:Plate#:
  🚗 Vehicle 3
Year:Make:
Model:Color:
State:Plate#:

Rental & Mortgage History
Tell us about your history with making rent or mortgage payments. If you do not have a history of making these types of payments, fill out only the first section for where you currently live. (required)
  🏠 Current Residence
 Address: (Street, City, State, Zip)
 
 Landlord or Mortgage Co.
 
 Phone:
 		  Payment:
 
 Reason for Leaving?
 
  🏠 Previous Residence 1
 Address: (Street, City, State, Zip)
 
 Landlord or Mortgage Co.
 
 Phone:
 		  Payment:
 
 Reason for Leaving?
 
 Date Range of Occupancy:
  to
  🏠 Previous Residence 2
 Address: (Street, City, State, Zip)
 
 Landlord or Mortgage Co.
 
 Phone:
 		  Payment:
 
 Reason for Leaving?
 
 Date Range of Occupancy:
  to

Income & Employment History
Tells us about your work history. If you have not held a job, fill out only the first section about your income source.
  💰 Income Sources
 Monthly Income:
 		Source(s):
  🏢 Current Employer
 Company:
 		  Title:
 		  Started:
 Address: (Street, City, State, Zip)
 
 Supervisor:
 		Phone:
  🏢 Previous Employer 1
 Company:
 		  Title:
 		  Started:
 Address: (Street, City, State, Zip)
 
 Supervisor:
 		Phone:
 Reason for Leaving?
 
  🏢 Previous Employer 2
 Company:
 		  Title:
 		  Started:
 Address: (Street, City, State, Zip)
 
 Supervisor:
 		Phone:
 Reason for Leaving?
 

Questionnaire
Please answer these questions concerning your personal history. (required)
 Do you smoke?
   No Yes
 If yes, please explain:
 
 Do you have any water-filled furniture to have in the house?
   No Yes
 If yes, please explain:
 
 Have you ever been evicted or in process of being evicted?
   No Yes
 If yes, please explain:
 
 Have you ever been convicted of a crime other than a motor vehicle violation?
   No Yes
 If yes, please explain:
 
 Have you ever filed for bankruptcy?
   No Yes
 If yes, please explain:
 

Personal References
Please provide at least one reference we can call on to discuss your eligibility (required)
  🙋 Reference 1
 Name:
 
 Relationship:
  		Years Known:
 Address: (Street, City, State, Zip)
 
 Phone:
 
  🙋 Reference 2
 Name:
 
 Relationship:
  		Years Known:
 Address: (Street, City, State, Zip)
 
 Phone:
 

Emergency Contact
In the event of an emergency, who is someome we can contact? (required)
 Name:
 
 Relationship:
 
 Address: (Street, City, State, Zip)
 
 Phone:
 

MoStateProperties, LLC is the owner of, or the agent for the owner of the rental property stated above. Please be advised that any information obtained may be shared with the owner of this property or their agents.

I certify that all of the information provided is true and accurate and that my rental agreement may be terminated if proven otherwise.

I authorize MoStateProperties, LLC to obtain a credit report, personal/criminal background check and an employment and residential history report concerning myself for the purpose of evaluating my qualifications for residency.
 Your E-Signature:
 Local Time:

PROPERTIES

PAY MY RENT

MAINTENANCE



'.$footer.' '; } ?>