APPLICATION FORM

Each adult applicant must fill out a separate application. Please feel free to answer the questions that you want.   * are mandatory fields

 

* FIRST NAME

* MIDDLE NAME

* LAST NAME

* DATE OF BIRTH

 

 

 

/            /

SOCIAL SECURITY NUMBER

-               -

* DRIVER LICENSE NUMBER

-         -         -         -

NUMBER OF DEPENDENTS

 

 

 

 

 

SINGLE

 

     MARRIED

 

  DIVORCED

 

  OTHER

 

 

 

 

 

 

 

 

 

HOW MANY CHILDREN DO YOU HAVE

 

    WHAT AGE

 

 

DO YOU HAVE PETS

 

YES

 

NO

WHAT KIND – HOW MANY

 

 

* HOW MANY PEOPE ARE PLANNING TO LIVE IN THIS APARTMENT

 

 

LIST ALL OCCUPANTS:              

* COMPLETE LEGAL NAME

RELATIONSHIP

AGE

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESSES:

 

ADDRESS

APT. #

CITY

STATE

ZIP CODE

HOME PHONE

* PRESENT

 

 

 

 

 

 

LAST

 

 

 

 

 

 

LAST - 1

 

 

 

 

 

 

LAST - 2

 

 

 

 

 

 

 

LANDLORDS:

 

NAME

PHONE

DATE IN

DATE OUT

RENT PAID

PRESENT

 

 

 

 

$

LAST

 

 

 

 

$

LAST - 1

 

 

 

 

$

LAST - 2

 

 

 

 

$

 

EMPLOYERS (IF EMPLOYED):

 

NAME

ADDRESS

PHONE

DATE IN

DATE OUT

SALARY PAID

PRESENT

 

 

 

 

 

$

LAST

 

 

 

 

 

$

LAST - 1

 

 

 

 

 

$

LAST - 2

 

 

 

 

 

$

 

EMPLOYERS DETAILS (IF EMPLOYED):

 

POSITION

SUPERVISOR’S NAME

SUPERVISOR’S PHONE

REASON FOR LEAVING

PRESENT

 

 

 

 

LAST

 

 

 

 

LAST - 1

 

 

 

 

LAST - 2

 

 

 

 

 

ADDITIONAL MONTHLY SOURCES OF INCOME: Part time, assistance, disability, other…

 

SOURCE

AMOUNT

PHONE

COMMENTS

# 1

 

$

 

 

# 2

 

$

 

 

# 3

 

$

 

 

 

CREDIT REFERENCES:

 

ACCOUNT NAME

ACCOUNT #

PHONE

COMMENTS

# 1

 

 

 

 

# 2

 

 

 

 

 

REFERENCES: (non relatives)

 

ADDRESS

CITY

STATE

ZIP CODE

HOME PHONE

FATHER

 

 

 

 

 

MOTHER

 

 

 

 

 

#1

 

 

 

 

 

# 2

 

 

 

 

 

 

AUTOS:

AUTO #

OWNED LEASED

MAKE

MODEL

YEAR

LICENSE PLATE #

MONTHLY PAYMENT

PAID TO WHOM

# 1

 O   /   L

 

 

 

 

$

 

# 2

O   /   L

 

 

 

 

$

 

# 3

O   /   L

 

 

 

 

$

 

 

HAVE YOU EVER:

BEEN EVICTED

 

YES

 

NO

BEEN SUED BY A LANDLORD

 

YES

 

NO

 

 

RECEIVED AN UNLAWFUL DETAINER

 

YES

 

NO

DECLARE BANKRUPTCY

 

YES

 

NO

 

 

CONVICTED OF A MISDEMEANOR

 

YES

 

NO

CONVICTED OF A FELONY

 

YES

 

NO

 

HAVE YOU EVER BROKEN A RENTAL AGREEMENT OR LEASE

 

 

YES

 

NO

 

 

 

 

 

 

 

I represent that the information contained in this application is true and complete to the best of my knowledge. I hereby authorize verification or re-verification of any information contained in this application to be made at any time by the property owner, its agents, successors, and assigns, either directly or through a credit reporting agency from any source named in this application. The property owner will rely on information in this application, and I have a continuing obligation to amend and/or supplement this information should it change at any time either before or during my tenancy. This application will be incorporated by reference as a part of my rental agreement, and any false statement will be grounds for immediate termination of tenancy.

.

 

Date :

 

 

Signature Applicant :

 

 

 

 

DO NOT WRITE BELOW

APARTMENT ADDRESS

 

 

DATE MOVE IN

            /          /    

 

RENT

$

 

NOTES