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Application Form

Email *

Full Name *

Phone *

Date of Birth *

Social Security Number *

*Security Number is required to lease.

Number of persons to reside in the apartment? *

Minor(s) Name(s)

Date(s) of Birth

Minor(s) Name(s)

Date(s) of Birth

Minor(s) Name(s)

Date(s) of Birth

Pets (Number and Kind) *

PLEASE GIVE YOUR RESIDENCE HISTORY FOR THE PAST 3 YEARS

(beginning with the most current)

Current Address *

City *

State *

Zip Code *

Month & Year Moved In *

Do you rent or own? *

Rent

Own

Name of community and/or landlord *

Amount of rent or mortgage paid per month *

Landlord's phone number *

_________________________________________________
If you have had an additional previous address in the last two years or less, please fill out the section below

Previous Address

City

State

Zip Code

Month & Year Moved In

Do you rent or own?

Rent

Own

Amount of rent or mortgage paid per month

Landlord's phone number

_________________________________________________

PLEASE GIVE YOUR EMPLOYMENT OR RETIREMENT INFORMATION & INCOME

Your status: *

Current employer/income source *

Position *

Dates employed *

Address *

City *

State *

Zip Code *

Gross Income *

Per *

Supervisor

Supervisor's Phone Number

Previous employer or school

PLEASE LIST YOUR BANK REFERENCES

Your Bank(s) *

Branch (city/state) *

Type of account *

Your driver's license number *

State *

Vehicle Year/Make/Model *

License Plate *

State *

Vehicle Year/Make Model

License Plate

State

Other Vehicles:

Have you ever filed for Bankruptcy? *

Yes

Have you ever been evicted from tenancy? *

Yes

Have you ever been willfully or intentionally refused to pay rent when due? *

Yes

Have you ever been convicted of or pleaded "guilty" or "no contest" to a Felony? *

Yes

(whether or not resulting in a conviction)

Have you ever been convicted of or pleaded "guilty" or "no contest" to a misdemeanor involving sexual misconduct? *

Yes

(whether or not resulting in a conviction)

Please give any additional information which might help management evaluate this application:

I hereby apply to lease the above described premises for the term and upon the conditions above set forth and agree that the rent is to be payable the 1st day of each month in advance. As an inducement to the owner of the property and the agent to accept application, I warrant that all statements above set forth are true. I agree to the payment of a $___________ non-refundable application fee to offset the cost of processing my application.

Upon acceptance of this application, I agree to execute a lease for _______months and further agree to pay the full Security Deposit and any rent due before possession is given. If I choose not to enter into a lease agreement, I agree to give written notice to the Community Manager within forty-eight (48) hours after application approval. Such notice shall entitle me to the return of any deposit made in connection with this application (except for the non-refundable application fee). My failure to timely notify the Community Manager shall result in a forfeiture by me of the total amount of any such deposit. If this application is rejected, I hereby waive any claim for damages by reason of non-acceptance which the owner or its agent may reject without stating any reason for doing so.

I authorize you to obtain an investigative credit report in connection with this application, including release of information by any bank, savings and loan, employer (present or former), landlord (present or former) and any lender. I understand that I can request the name of the reporting agencies providing this information. The owner does business in accordance with the Fair Housing Act (The Civil Rights Act of 1968 as amended by the Fair Housing Amendments Act of 1988), which provides that it is illegal to discriminate against any person because of race, color, religion, sex, handicap, familial status (having one or more children) or national origin in the rental of housing.

NOTICE: BY SIGNING THIS APPLICATION, YOU DECLARE THAT ALL OF YOUR RESPONSES ARE TRUE AND COMPLETE AND AUTHORIZE OWNER TO VERIFY THIS INFORMATION. ANY FALSE STATEMENT ON THIS APPLICATION CAN LEAD TO REJECTION OF YOUR APPLICATION OR IMMEDIATE TERMINATION OF YOUR LEASE.

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