What Unit are you applying for?
Full Name Email Address
Maiden name (if applicable) Social Security #
Date of Birth Telephone # Drivers License #
Current Address City State Zip
Lived there since Rental Amount Weekly Monthly (check one)
Current Landlord Landlords Telephone #
Address City State Zip
Reason for moving
____________________________________________________________________________________________________
In case of emergency notify:
Name Relationship Telephone #
Non Relative Reference NOT living with you:
Others to Occupy Apartment:
Name Social Security # Relationship Date of Birth
Present Employer Supervisor's Name
Telephone # Employed Since Salary $ Weekly Monthly
Previous Employer Supervisor's Name
Telephone # Employed from/to Salary $ Weekly Monthly
______________________________________________________________________________________________________
Other Income:
Source Amount Weekly Monthly
_______________________________________________________________________________________________________
Bills owed:
Debt Type Amount Owed$ Payment$ Weekly Monthly
Automobile make/model Year Color License Plate # State
What types of pets do you own?
Have you ever had a court action brought against you by a landlord or have you ever brought a court action against a landlord (such as an eviction, small claims, etc.)? Yes No If yes, please explain fully :
Have you ever filed for bankruptcy? Yes No Had a Judgment against you? Yes No
Have you ever been convicted of or pleaded guilty or “no contest” to a felony? Yes No
Have you ever been convicted of or pleaded guilty or “no contest” to a misdemeanor including sexual misconduct? Yes No
The undersigned authorizes that:
Credit reports be obtained from any consumer reporting agency, verification of my rental history be obtained from landlords, property management companies, or any other sources, employment verification and history be obtained from present and past employers, and references be obtained from any source which could attest to my credibility, suitability, and worthiness to rent a housing accommodation. The undersigned also warrants and represents that all statements herein are true. Any false or misleading information on this application may result in immediate termination of the lease. If you are approved for a dwelling unit, you authorize the landlord to report your name to the appropriate Consumer Credit Reporting Agency as the occupant of this dwelling unit. This application may also be released to any company, agency, etc. upon their request. Applicant understands and agrees that the application may be rejected at any time, even after initial approval, until the lease is signed.
*****NOTICE*****
If you are approved to rent a dwelling unit, and we later discover you are a narcotics' user or dealer, we will immediately report this illegal activity to the local police authorities. We will also willingly participate, if requested, to testify against you and submit any information you give us on your application as evidence. Beware that law-abiding residents of our buildings are aware of the types of activity that signal the presence of drug dealers and they have been instructed to contact us immediately upon discovery of such activity.
Note: A $_________ non-refundable application fee and Photo ID are required at time of application
Electronic Signature (please type complete name) Date
DO NOT WRITE BELOW THIS LINE
Type of ID ____________________________________________________
Name _____________________________________________
Address _____________________________________________________
City ___________________________________ State _________________ Zip __________________
DOB ____________________________ License # _____________________________
SS# _________________________ Height _________________ Date Issued _________________________
