Full Name:                                                                               S.S.#:                                             Date of Birth:

Email:                                                                                  Phone #:                                       Driver's License:  

Do You Have a Child Who Will Be Living With You? ______   Age:  _____  (Occupancy Limit:  2 person/1 bedrm, 1 person/Studio)

 

How did you hear about this complex? 

 

Current Address:                                                                                              

Current Landlord's Name:                                                                                                            Phone Number:

May I Call for a Reference?    ____ Yes    _____ No                                                          Current Rent Amount:

How Long There?  _________     Prior Address (if less than 3 years):  

Why are You Moving?

Have you ever been evicted or had a tenancy agreement terminated by the landlord?   ______.    If yes, provide: 

Name and Address of Landlord:

Reason for Eviction:

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Current Employer:                                                                                                  Work Phone:

Address:                                                                                                       Supervisor's Name:

Gross Monthly Income:  ___________   How long with this Employer?  ________

May I call for a Reference?   _____  Yes      ______  No

References:     Name:                                                        Relationship:                                    Phone Number:   

                          Name:                                                        Relationship:                                    Phone Number: 

 

How is Your Credit?               _____  Good    ______  Fair     _____  Ooops

Taking into account your other expenses, can you afford this unit?          ______  Yes        _______  No

 

Criminal Record:  Has applicant been convicted of a felony in a State or Federal Court?  _______   If Yes, provide:

                            Dates:                                                                 Nature of Offense:

                            Court:                                                                  Penalty Imposed:

                            Date Civil Rights Restored, if applicable:

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Applicants's Personal Property:   Do you own pets?  _____   Number _____   Kind ______

                             Do you Own a Vehicle?  _____        Year ______     Model _______________________     License No: __________________ 

 

Person to Notify in case of emergency:                                                                         Phone #:  

      2nd Person to Notify in emergency:                                                                         Phone #:

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Applicant declares the foregoing information is true and complete.  Providing false information on the application is grounds for termination.  Applicant authorizes Landlord to obtain information regarding credit history, confidential information and criminal background from any source and/or anyone listed on this form.

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Signature:    ________________________________________________       Date:  ___________________________

                                                

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