TENANT's APPLICATION.

Los Angeles, Cal........190.......

Messrs. Wright & Callender:

I hereby make application for the rental of premises described below, upon the following terms, and warrant all statements made in application to be correct.

Name in full...... Residence...... Tel. No....... Business Address

...... Tel. No....... Occupation...... Number in family......1 Number of children...... Oldest child...... Sex...... Youngest child......

Sex...... Any illness in family?...... Do you expect to rent rooms?

...... Or keep boarders?......

I desire to rent No.......For Term of...... From......At $......

per month, water paid by...... Deposit $...... Subject to......

References: Present landlord or agent...... Other references......

If any of above statements are found to be false, I hereby agree to forfeit said deposit.

Witness............... Signed.............. (Seal)

Owner........ Address........ Tel. No......... Approved by........

Reference examined by......