COLVIN’S DUPLEX RENTALS, L.L.C.

P.O. Box 271 RUSTON, LA. 71273-0271
318-245-5459 Fax 318-254-1198

Please fill out this form, print it and fax to: 318-254-1198. This form cannot be submitted via the Internet.









I understand that by submitting a rental or deposit payment for an apartment, that I have committed to a one year agreement, subject to application verification, credit/background check, and approval, and I will lose my rental or deposit payment if I change my mind. Rental or deposit monies will be refunded if the application is not approved. I understand that the lease is available online to read and approve before I make this commitment. I give my permission for a credit/background check and employment/income verification for the purpose of this rental.

(SIGNATURE REQUIRED-may be evidenced by facsimile)

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WE RESERVE THE RIGHT TO REFUSE SERVICE TO ANYONE.

Please fill out this form, print it and fax to: 318-254-1198. This form cannot be submitted via the Internet..