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Application Disclosures (will open a new page)


 

First Name

Last Name

Date of Birth

Social Security #

#1

#2

3

4


Housing References

#1

Present Address:

Apt #
 

City

State

Zip

Home Phone
 

Name of Landlord/Manager:

Phone
 

Start Date:

End Date:


#1

Previous Address:

Apt #
 

City

State

Zip

Home Phone
 

Name of Landlord/Manager:

Phone
 

Start Date:

End Date:


#2

Present Address:

Apt #
 

City

State

Zip

Home Phone
 

Name of Landlord/Manager:

Phone
 

Start Date:

End Date:


#2

Previous Address:

Apt #
 

City

State

Zip

Home Phone
 

Name of Landlord/Manager:

Phone
 

Start Date:

End Date:


Do you have a pet?

If yes, what type?

Have you ever been evicted?

Had an apartment lease NOT renewed?

Declare bankruptcy?

Please explain:


Employment

#1

Present Employer:

Position
 

Address:

Phone
 

Start/End Date:

Supervisor:

Supervisor's Phone


#2

Present Employer:

Position
 

Address:

Phone
 

Start/End Date:

Supervisor:

Supervisor's Phone


Income

#1

Gross Monthly Income Amount $

Other Source(s):

Amount $

#2

Gross Monthly Income Amount $

Other Source(s):

Amount $


Automobiles

#1

Make & Model:

Year:

Vechicle Lic Num:

Drivers Lic Num:

#2

Make & Model:

Year:

Vechicle Lic Num:

Drivers Lic Num:


The undersigned agree(s) that the landlord shall have up to twenty-one (21) days from acceptance of the earnest money deposit to approve or deny the rental application. Within eight (8) days after the start of tenancy, tenant may (1) request, in writing, that landlord provide tenant with a list of physical damages or defects, if any, charged to previous tenant's security deposit and (2) inspect the dwelling unit and notify the landlord of any pre-existing damages or defects.


In order to be considered complete, this application must be accompanied by an earnest money deposit of $25.00 per adult (check or money order only); deposit to be returned if application is not approved, if approved, this sum to be applied to security deposit. If applicant decides not to enter into rental agreement after application approval, actual costs and damages incurred will be deducted from deposit. Applicant consents to routine inquiry of reference and credit agencies and verify applicable application disclosures. This application is subject to approval of landlord or landlord's agent.


TO THE BEST OF MY KNOWLEDGE ALL THE ABOVE INFORMATION IS TRUE. ANY FALSE INFORMATION WILL RESULT IN REJECTION OF APPLICATION.


Email Address


Disclosures:
I HAVE READ, UNDERSTAND, AND AGREE WITH THE APPLICATION DISCLOSURES:
Yes     No
Application Disclosures (will open a new page)


#1

Signature:

Date:

#2

Signature:

Date:


Do you wish to receive a written explanation of denial?
Yes     No


Lease Start Date:

End Date:

Apartment(s):

Rent $

Rent is per month, plus gas & electric.
Security Deposit is one-half of a month's rent.


How did you hear about us?


What made you decide to apply here versus elsewhere?




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