Application for Apartment Rental

Application for Rental

PO Box 1090, Maumee, Ohio 43537

Phone: 419-690-3629

Full Name: ______Social Security Number: ______

Present Address: ______

City: ______State: ______Zip:______

E-mail:______Gender: M:_____ F:____

Date of Birth: ______Drivers License No: ______State:____

Present Phone No:______Are you a U.S. Citizen:Yes____ No____

Current Rent per month: ______

Landlord Name: ______Landlord Phone: ______

Current Employment: ______Income: ______

Employment Address:______

City:______ State:______Zip:______

Phone No:______Position: ______Length: ______

Other Sources of Income: ______Amount of Income: ______

Co-Applicant Full Name:______Social Security Number: ______Present Address:______

City:______ State:______Zip:______

E-mail:______Gender: M:_____ F:____

Date of Birth: ______Drivers License No: ______State:____

Present Phone No: ______Work Phone No: ______

Current Employment: ______ Income: ______

Employment Address:______

City:______ State:______Zip:______

Phone No:______Position: ______Length: ______

Other Sources of Income: ______Amount of Income: ______

Occupant Name (under 18 years of age)______

How did you hear about this location?

Newspaper ____ Flyer ____ Drive-by ____ Web ____ Other ______

Were you referred by a friend? Yes____ No____ Name of Friend: ______

If you will be parking a car on the premises, please provide the following:

Make:______Year: ______License Plate No: ______

In Case of Emergency Notify: ____________

Emergency Phone: ______Address: ______

City:______State:______Zip: ______

Lease Starting Date:______

Do you have special apartment needs? ______

Apartment Preference: ___1 Bedroom ___2 Bedroom___3 Bedroom

Your Rental/Criminal History:

Check only if applicable.Have you ever:

____ Been evicted or asked to move out of a residence? ____ Moved out of a dwelling before the end of the lease term without the owner’s consent? ____Declared bankruptcy? ____ Been sued for rent? ____ Been sued for property damage? ____ Been charged, detained, or arrested for a felony or sex crimes that was resolved by conviction, probation, deferred adjudication, court ordered community supervision, or pretrial diversion? ____ Been charged, detained or arrested for a felony or sex-related crime that has not been resolved by any method?Please indicate below the year, location and type of each felony and sex crime other than those resolved by dismissal or acquittal. We may need to discuss more facts before making a decision.You represent the answer is “no” to any item not checked above.

______

Consumer Authorization to Obtain Consumer Report:

“I hereby authorize Destiny Enterprises, LLCto obtain a consumer report, and any other information it deems necessary, for the purpose of evaluating my application. I understand that such information may include, but is not limited to, credit history, civil and criminal information, records of arrest, rental history, employment/salary details, vehicle records, licensing records, and/or any other necessary information. I hereby expressly release Destiny Enterprises, LLC, and any procurer or furnisher of information, from any liability what-so-ever in the use, procurement, or furnishing of such information, and understand that my application information may be provided to various local, state and/or federal government agencies, including without limitation, various law enforcement agencies.”

Applicant verifies that the information provided is true and accurate:

Applicant’s Signature: Date:

Office Use Only

___ $50 Application Fee Received ___ Background Check Ordered ___ Credit Check Ordered

___ Other ______

Equal Housing Opportunity

Housing is available to all without regard to race, color, religion, sex, handicap, or national origin