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2019-04-08T14:15:58+00:00
Application Form
PERSONAL INFORMATION
First Name
*
Middle Name
*
Last Name
*
S.S #
*
Date of Birth
*
Status
*
---
Single
Married
Divorced
Engaged
Driver's License #
*
License State
*
Phone Type
*
---
Cell Phone
Home Phone
Work Phone
Phone Number
*
Email
*
Present Home Address
*
Present Home Address
Address 1
Address 1
Address 2
Address 2
City
City
State
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip
Zip
Length of Time
*
Present Landlord
*
Landlord Phone
*
Reason for Leaving
*
Amount of Rent
*
Is Your Present Rent Up to Date?
*
---
Yes
No
Previous Home Address
Previous Home Address
Address 1
Address 1
Address 2
Address 2
City
City
State
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip
Zip
Length of Time
Previous Landlord
Landlord Phone
Reason for Leaving
Amount of Rent
Was Your Previous Rent Up to Date?
---
Yes
No
PROPOSED OCCUPANT(S)
Every occupant must be listed on each application. Every occupant over 18 must fill out their own application.
Name
Relationship
Occupation
Age
PROPOSED PET(S)
Pet fees and restrictions will apply
If pet is approved, do you agree to a monthy fee?
*
---
Yes
No
N/A
Name
Type/Breed
Indoor/Outdoor
---
Indoor
Outdoor
Both
Weight
Name
Type/Breed
Indoor/Outdoor
---
Indoor
Outdoor
Both
Weight
Name
Type/Breed
Indoor/Outdoor
---
Indoor
Outdoor
Both
Weight
VEHICLE(S) INFORMATION
Year
Make
Model
Color
Plate #
State
Year
Make
Model
Color
Plate #
State
EMPLOYMENT
Current Employer
*
Occupation
*
Hours per Week
*
Address
*
Address
Address 1
Address 1
Address 2
Address 2
City
City
State
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip
Zip
Previous Employer
Occupation
Hours per Week
Address
Address
Address 1
Address 1
Address 2
Address 2
City
City
State
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip
Zip
RENTAL ASSISTANCE
Rental Assistance/Subsid Type
Voucher Amount
Expiration Date
Case Number
Case Worker Name
Case Worker phone #
INCOME SOURCES
Please list as many as possible
Income Amount
*
Frequency
*
---
Weekly
Bi-Weekly
Monthly
Source
*
---
Job
SSI
Child Support
Other(specify)
Other
*
Proof of Income
*
---
Bank Letter
Past Stub
Income Amount
Frequency
---
Weekly
Bi-Weekly
Monthly
Source
---
Job
SSI
Child Support
Other(specify)
Other
Proof of Income
---
Bank Letter
Past Stub
CREDIT CARD / FINANCIAL INFORMATION
Car Loan/Lien Holder
Due Monthly
Phone Number
Address
Credit Card Company
Due Monthly
Phone Number
Address
Credit Reference
Due Monthly
Phone Number
Address
Credit Reference
Due Monthly
Phone Number
Address
Name of Bank
Due Monthly
Phone Number
Address
EMERGENCY CONTACT
Name
*
Phone Type
*
---
Cell Phone
Home Phone
Work Phone
Phone Number
*
Relation
*
PERSONAL REFERENCE
Name
*
Phone Type
*
---
Cell Phone
Home Phone
Work Phone
Phone Number
*
Relation
*
APPLICATION QUESTIONNAIRE/AUTHORIZATION
Has applicant ever been sued for bills?
*
Yes
No
Has applicant ever been locked out of their apartment by the sheriff?
*
Yes
No
Has applicant ever been bankrupt?
*
Yes
No
Has applicant ever been brought to court by another landlord?
*
Yes
No
Has applicant ever been guilty of a felony?
*
Yes
No
Has applicant ever moved owing rent or damaged an apartment?
*
Yes
No
Has applicant ever been arrested or charged for drug possession or sale?
*
Yes
No
Is the total move-in amount available now (rent and deposit)?
*
Yes
No
Have you been evicted from prior residence?
*
Yes
No
Do you use tobacco or electronic smoking devices?
*
Yes
No
How were you referred to us?
*
Newspaper
Craigs List
Realtor
Other
Other
*
Applicant authorizes the landlord to contact past and present landlords, employers, creditors, credit bureaus, neighbors and any other sources deemed necessary to investigate applicant. All information is true, accurate and complete to the best of applicant’s knowledge. Landlord reserves the right to disqualify tenant if information is not as represented. ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FORM AT ANY TIME. If you have any questions about the interpretation or legality of this form, please consult an attorney or other qualified Person.
Applicant Signature
*
Date
*
agreement
*
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
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