Flugel Properties, LLC www.flugelproperties.com Page 1 of 6
RESIDENTIAL RENTAL APPLICATION
Property Address Rental Amount
Heat Electricity Water W/D Other
Security Deposit 1 months’ rent Earnest Money $100 Lease Term 1 year
COMPLETE THE FOLLOWING FOR EACH PERSON WHO WILL OCCUPY THE UNIT:
Name Relationship Birthdate w/ year
CONTACT INFORMATION FOR ADULT APPLICANTS:
First name Email Phone (is this a home or cell number?)
COMPLETE THE FOLLOWING FOR ALL VEHICLES THAT WILL BE KEPT ON PREMISES:
License plate # State Make, model, year
HOUSING REFERENCES (Must include 2 landlord references and housing for past 3 years)
Rental Address 1
From ______To ______Rental Amount
Landlord Name Landlord phone
Landlord Email Landlord fax
Landlord Address ______
Rental Address 2
From ______To ______Rental Amount
Landlord Name Landlord phone
Landlord Email Landlord fax
Landlord Address ______
Rental Address 3
From ______To ______Rental Amount
Landlord Name Landlord phone
Landlord Email Landlord fax
Landlord Address ______
Rental Address 4
From ______To ______Rental Amount
Landlord Name Landlord phone
Landlord Email Landlord fax
Landlord Address ______
EMPLOYMENT
Income information—INCLUDE ALL SOURCES OF INCOME
PLEASE LIST EMPLOYMENT REFERENCES COVERING THE PAST 2 YEARS
Employer______Position ______
Employer Address ______
Phone # (____)______Supervisor Name ______From _____ To _____
Amount of Income ______/Year ______/Month ______/Hour
Employer______Position ______
Employer Address ______
Phone # (____)______Supervisor Name ______From _____ To _____
Amount of Income ______/Year ______/Month ______/Hour
Employer______Position ______
Employer Address ______
Phone # (____)______Supervisor Name ______From _____ To _____
Amount of Income ______/Year ______/Month ______/Hour
Employer______Position ______
Employer Address ______
Phone # (____)______Supervisor Name ______From _____ To _____
Amount of Income ______/Year ______/Month ______/Hour
PERSONAL REFERENCES (DO NOT LIST RELATIVES AS REFERENCES)
Name ______
Full Address ______
______
Phone (____) ______Relationship ______Years known ______
Name ______
Full Address ______
______
Phone (____) ______Relationship ______Years known ______
Name ______
Full Address ______
______
Phone (____) ______Relationship ______Years known ______
EMERGENCY CONTACT (Please list someone in the area if possible)
Name ______
Full Address ______
______
Daytime phone (____) ______Evening phone (____) ______
Relationship ______Years known ______
ANSWER EACH OF THE FOLLOWING QUESTIONS YES OR NO
You may attach additional sheets of paper for explanation if necessary
Y N Any other source of income not listed?
Explanation: ______
Y N Social Security, SSI, or any other payment from Social Security Administration?
Explanation: ______
Y N Do you have full custody of your child/children?
Explanation of custody arrangements: ______
Y N Do you expect any additions to the household within the next 12 months?
Explanation: ______
Y N Have you ever filed for bankruptcy?
Explanation: ______
Y N Have you ever been convicted of a felony?
Explanation: ______
Y N Have you ever been evicted from an apartment for any reason?
Explanation: ______
All questions that were answered Yes will be verified through the appropriate third-party source. It is your responsibility to provide Michael Piette with all necessary information to properly process your application and verify your eligibility. This will include names, addresses, phone numbers and account numbers where applicable and any other information required to expedite this process.
SIGNATURE CLAUSE
I understand that Flugel Properties is relying on this information to prove my household’s eligibility for renting an apartment from them. I certify that all information and answers to the above questions are true and complete to the best of my knowledge. I consent to release the necessary information to determine my eligibility. I understand that providing false information or making false statements may be grounds for denial of my application. I also understand that such actions may result in criminal penalties.
I authorize my consent to have Flugel Properties (Michael Piette, manager) verify the information contained in this application for purposes of proving my eligibility for occupancy. I will provide all necessary information and expedite this process in any way possible. I understand that my occupancy is contingent on meeting Flugel Properties’ resident selection criteria. I authorize Flugel Properties (Michael Piette, manager) to run a credit check on me.
Earnest Money Received $ 100 Date
Cash / Check made out to Flugel Properties LLC
If you are accepted the earnest money becomes a portion of the Security Deposit due. If you are not accepted, then your earnest money will be returned to you. If you are accepted and you change your mind you forfeit the earnest money held. At the time of entering into a rental agreement the applicant agrees to pay the balance due of the security deposit and the first month’s rent. If the applicant refuses to enter into a rental agreement after this application has been approved, actual costs and damages incurred will be deducted from the deposit. Deposits may also be withheld as compensation for lost rent if the landlord makes reasonable effort to mitigate the rental loss in accordance with 704.29 Wisconsin Statutes.
For credit check: Social Security number and DL# for each adult that will occupy the unit:
Name Social Security Number Driver’s License # State
ALL ADULT HOUSEHOLD MEMBERS MUST SIGN BELOW:
Signature Date
Signature Date
Signature Date
Michael Piette, 712 E Court St, Janesville WI 53545.
Home: (608) 752-5276. Cell (608)772-2010. Email