Garden Park Management Co

GARDEN PARK

MANAGEMENT CO., INC.

513 Main Street l Springfield, MA 01105 l Tel (413) 739-9774 / Fax (413) 739-7189

Garden Park Management Co., Inc.

513 Main Street∙ Springfield, MA 01105

Phone: (413) 739-9774 ∙ Fax (413) 739-7189

APPLICATION FORM

This application must be complete or it will be rejected!

NO PETS – NO WATERBEDS

Date

Date ______Rec’d

Name ______

Present Address ______Town ______Zip ______

Date of Birth ______Social Security ______

Home Phone ______Work Phone ______

Email Address ______

RACE (This information will be used only for the affirmative marketing program as required by federal and state laws and is optional).

⁯ Black ⁯ Spanish American ⁯ Native American

⁯ Asian ⁯ White ⁯ Other (specify) ______

PLEASE CHECK YOUR PREFERENCE IN APARTMENT LOCATION:

Bel-Air Homes (3–4 BR’s - Allendale, Hebron, Dwight, Bancroft) ______

Citywide Associates (0-1BR’s - Acushnet, Myrtle, Main, Wendell, Marble) ______

Chateau (0-2BR’s - Maple, Temple) ______

CNI Corp (2-3BR’s – Bay St., Belmont, Grosvenor, Chestnut, Montmorenci) ______

PRESENT APARTMENT: Size ______No. of Occupants ______Subsidized: ⁯ Yes ⁯ No

Address ______Town ______

Name of Present Landlord ______Telephone ______

Address of Present Landlord ______Town ______

How long have you lived there? ______

PREVIOUS APARTMENT: Size ______No. of Occupants ______Subsidized: ⁯ Yes ⁯ No

Address ______Town ______

Name of Previous Landlord ______Telephone ______

Address of Previous Landlord ______Town ______

How long have you lived there? ______

*Landlord history required for the last five years.

WHAT LANGUAGE CAN YOU BEST COMMUNICATE IN: ______

DO YOU REQUIRE AN APARTMENT MODIFIED FOR A WHEELCHAIR? ______

DO YOU REQUIRE ANY OTHER REASONABLE ACCOMODATION? ______

ARE YOU CURRENTLY RECEIVING RENTAL SUBSIDY ______

Garden Park Management Application - continued

EMPLOYMENT: Company Name ______

Name of Supervisor ______Phone ______

Business Address ______Town ______

Length of Employment ______Annual Wages ______

Comments ______

If other household members are employed, complete the following:

Name of family member ______Age ______

Where Employed ______

Name of Supervisor ______Phone ______

Business Address ______Town ______

Length of Employment ______Annual Wages ______

Comments ______

OTHER SOURCES OF INCOME:

Unemployment $ ______

Retirement $ ______

Disability $ ______

Social Security $ ______

AFDC $ ______

Other Assistance $ ______

Child Support $ ______

Pension $ ______

Other $ ______Please Clarify: ______

TOTAL MONTHLY INCOME: $ ______

ASSETS

Please list all of your Savings/Checking Bank Accounts

Bank Amount Account #

1. ______

2. ______

3. ______

INVESTMENTS

Value Dividends

Stocks ______

Bonds ______

Real Estate ______

CD’s ______

Life Insurance ______

In case of emergency, whom should we call?

Name ______Relationship ______Phone ______

Address ______City______State ______Zip ______

Garden Park Management Application - continued

Please list all people who will occupy the apartment:

Name Date of Birth Sex Social Security Relationship

______

* Please indicate any persons who are 18 years or older and are full-time students.

Name School Location

______

Note: It is standard policy and practice for Garden Park Management Co. to reject any application that is incomplete in any area of the application and to reject any application that is found to contain untruthful answers or statements.

PLEASE ANSWER THE FOLLOWING QUESTIONS:

1. Are you currently using illegal drugs or any controlled substance that hasn’t been prescribed to you?