Application for Residency Auburn Glenn Apartments

A separate application is required for each unmarried occupant that is or will be 18 years or older within the next twelve months. Married couples may complete one.

Thank you for fully completing this application. All questions must be answered, please use ‘none’ or ‘zero’ as needed. If an error occurs, please put one line through it, make and initial the correction, and date it.

When do you want to move in? ______What Size Apartment do you require? ______

mm / dd / yy

Applicant and Family Information
Marital Status (check one) / Never Married / Divorced
WB 22-AA / Separated
WB 25-EA / Widowed / Married
Home Phone # / Work Phone # / Cell Phone #
List all permanent household members who will live in the apartment home during the next 12 months and any temporarily absent family members, foster children / adults, unborn children or Live-in Care Attendants.
Full Legal Names of All Household Members / Relationship to Head of Household / Date of Birth / Age / Social Security Number / Is this person a Full-time Student? * (Yes or No)
WB -40SS
1. / Self – Head of Household
2.
3.
4.
5.
6.
7.
Do you anticipate any additional occupants to join your household within the next twelve months? (check one) Yes No If yes, please explain ______
______
* A full-time student is any individual who is current enrolled in an educational institution on a full-time basis, expects to be enrolled during the balance of the current tax year (January to December) or has been enrolled on a full-time basis for at least 5 months out of the current calendar year.
For Office Only – If there are occupants under 18 years of age, not residing in this unit with both biological parents – obtain WB-21
Employment Income: / List ALL full-time or part-time employment, including self-employment of ALL household members and the anticipated income from each source of employment during the next 12-month period
Head of Household / Are you? Circle One Employed Full Time Employed Part Time Self Employed Unemployed seeking employment Unemployed Not Seeking
Current Employer: / Business Telephone # / Fax #
Address: / City: / State: / Zip:
Employed From: / To: / Position:
Payroll / Supervisor: / Gross Monthly Income: / $ / Include bonuses, overtime, tips, commission, etc.
Previous / Second Employer
(If less than 1 year at current position) / Business Telephone # / Fax #
Address: / City: / State: / Zip:
Employed From: / To: / Position:
Payroll / Supervisor: / Gross Monthly Income: / $ / Include bonuses, overtime, tips, commission, etc.
Spouse of Household / Are you ..Circle One … Employed Full Time Employed Part Time Self Employed Unemployed seeking employment Unemployed Not Seeking
Spouse’s Employment Income
Current Employer: / Business Telephone # / Fax #
Address: / City: / State: / Zip:
Employed From: / To: / Position:
Payroll / Supervisor: / Gross Monthly Income: / $ / Including bonuses, overtime, tips, commission, etc.
Previous / Second Employer
(If less than 1 year at current position) / Business Telephone # / Fax #
Address: / City: / State: / Zip:
Employed From: / To: / Position:
Payroll / Supervisor: / Gross Monthly Income: / $ / Including bonuses, overtime, tips, commission, etc.

How Did You Hear About Us: ______Applicant Name: ______

WILL YOU BE BRINGING A PET? ( ) Yes ( ) No IF YES, WHAT TYPE?______Weight______

DOES ANY OCCUPANT HAVE A DISABILITY THAT REQUIRES A HEARING AND/OR SEEING EQUIPMENT UNIT? ( ) Yes ( ) No

DOES ANY OCCUPANT HAVE A DISABILITY THAT REQUIRES A MOBILITY ASSESSIBLE EQUIPMENT UNIT? ( ) Yes ( ) No

HOUSING HISTORY:

Current

Address: ______Apt. # ______Payment Amount: $______Date From: ______Date To:______

Street Name

______Landlord's Name/Phone #______

City State Zip Code (required) County Own? ( ) Yes ( ) No

______Landlord’s Address:______

Reason for Moving

Previous

Address: ______Apt. # ______Payment Amount: $______Date From: ______Date To:______

Street Name

______Landlord's Name/Phone #______

City State Zip Code (required) County Own? ( ) Yes ( ) No

______Landlord’s Address:______

Reason for Moving

OTHER INFORMATION:

Driver's License #: ______State: ______Expires: ______

Vehicle Model:______Year:______License plate #:______

Nearest Living Relative ______

Name Phone Relationship

Address:______

In case of emergency Contact: ______

Name Phone Relationship

Address:______

Applicant Name: ______

Income Information
Please indicate each source of income received or anticipated within the next 12 months (please answer all questions).
Description of Income or Status / Receives Now or Anticipates receiving
check appropriate box / If Yes, Household Member’s Name / Gross Amount received monthly / For Office Use Only
If Yes, Form(s) as needed
Employment / Anticipated Employment / Yes No / $ / WB-20–VOE / If ‘no’ 27UE
Spouse Employment / Anticipated Employment / Yes No
Anyone Self-Employed? / Yes No / WB-24-SE
Is there a court order to receive child support or Alimony? / Yes No / WB-21-CS or 22-AA & Copy of court
Are you (or your spouse) receiving Child Support or Alimony
not order by the court? / Yes No / WB-21-CS or WB-22 AA
Unemployment Benefits / Yes No / Award Letter
Social Security, SSI, SSD / Yes No / Award Letter
V.A. Benefits / Yes No / Award Letter
TANF (AFDC) / Yes No / Award Letter
Disability, Worker’s Comp / Yes No / Agency Letter
Recurring Gift of Monetary or non-monetary (i.e. clothing, ) / Yes No / WB-23-RG
Regular Payments from Retirement Account / Yes No / Statement of Activity
Financial Aid (grants, scholarships, etc.) / Yes No / Award Letter
Income from a Temporarily Absent Family Member / Yes No / Appropriate Support
Other: Type / Yes No / Appropriate Support
For Office Only - - If no income listed above, applicant must complete WB-29ZI –
Housing Assistance / Yes No / If Yes, Which Public Housing Authority?
Asset Information
Please include all assets, including assets for children (all questions must be answered)
Description of Asset / Currently Have (check appropriate box) / If Yes, Household Member’s Name / Value / For Office Use Only
If Yes, is value on WB3-AA
Asset Addendum
Checking Account - (Average 6 Balance) / Yes No / Is the value on WB 3-AA ?
Savings Account (Current Balance) / Yes No / Is the value on WB 3-AA ?
Cash on Hand / Yes No / Is the value on WB 3-AA ?
Retirement Plan Account IRA / Keough / Pension / 401k / Yes No / Is the value on WB 3-AA ?
Do you current own any Real Estate / Yes No / WB–33-HW
Stocks, Bond or Mutual Accounts / Yes No / Is the value on WB 3-AA ?
Annuities / Yes No / Is the value on WB 3-AA ?
Life Insurance Policy (not Term) / Yes No / Is the value on WB 3-AA ?
Trust Account / Yes No / Is the value on WB 3-AA ?
Have you disposed of any Assets for less than Fair Market Value in the past 2 years? / Yes No / Is the value on WB 3-AA ?

I hereby apply to lease the above described premises on substantially the terms set forth herein. I warrant that all statements contained herein are true. I have been advised and understand that residency at this community entails certain income restrictions and that residency is subject to qualification. I authorize the owner and/or their agents to procure a consumer report as defined in the Fair Credit Reporting Act, 15 U.S.C. 1881 a (d) seeking information on the credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. I tender an application fee in the amount of $______which I acknowledge is the cost of procuring a consumer credit report, employment verification, character references and other costs of applying. This application fee is non-refundable. I agree that in addition to execution of a Lease Agreement that I will execute a tenant certification attesting to the information contained herein which certification will be made under the penalty of perjury.

A deposit of $ ______is made herein. If the application is approved, said deposit will be held as (partial/full) security for the performance of the covenants of the lease and as a damage deposit. The full security deposit will be $ ______. If the applicant(s) notifies the Landlord within three (3) days after the execution of this application that applicant(s) no longer wishes to rent said apartment, Landlord agrees to return said deposit in full. Landlord reserves the right to retain the security deposit if, for any reason, prospective resident withdraws the application for tenancy, if said application is withdrawn after the time limit set out in the previous sentence.

By execution of this application, I hereby authorize the owner of this property and/or their agents to make such investigations into my credit history as they may deem appropriate. I understand that such investigations typically include (but are not limited to) verification of employment, salary, rental history, consumer credit reports, and other information disclosed in the application or information obtained during the course of the approval process. By signing below, the applicant gives permission to procure a criminal background check and understands the results of such background check could affect the approval of this application.

Applicant: ______Date:______

Application taken by: ______Date: ______Credit/Criminal check by: ______Date: ______Approved by: ______Date: ______

WB-2APP - (rev 3/2011)