RESIDENCY APPLICATION & INFORMATION

Name of Applicant: Phone: ( )______

S.S. Number: ( )– ( ) – ( ) Date of Birth: / /______

Drivers License # State:______

E-Mail:______

Co- Applicant: Phone: ( )______

S.S. Number: ( )– ( ) – ( ) Date of Birth: / /______

Drivers License # State:______

E-Mail:______

Other Occupants:

Name:______Date of Birth: / / __Relationship:______

Name:______Date of Birth: / / __Relationship:______

Name:______Date of Birth: / / __Relationship:______

Applicant EMPLOYMENT INFORMATION:

Present Employer (applicant):______Occupation/Title:______

Employer’s Address: Street:______

City:______State: Zip:______

Employer’s Phone: ( )______Monthly Income:______

Length of employment:______

Previous Employer (applicant):______Occupation/Title:______

Employer’s Address: Street:______

City:______State: Zip:______

Employer’s Phone: ( )______Monthly Income:______

Present Employer: (Co-Applicant):______Occupation/Title:______

Employer’s Address: Street:______

City:______State: Zip:______

Employer’s Phone: ( )______Monthly Income:______

ADDITION INCOME INFORMATION

Source of Additional Income:______Monthly Amount:______

RESIDENCY INFORMATION

Apply for: □ 2 bedrooms or □ 3 bedrooms

Move in date: ______

Current Street Address:

City: State: Zip Code:

Monthly Rent: $ Deposit Paid: $ Lease Start Date: Lease End Date:

Landlord Name: Phone:______

Previous Street Address:

City: State: Zip Code:

Monthly Rent: $ Deposit Paid: $ Lease Start Date: Lease End Date:

Landlord Name: Phone: _

Has anyone listed on this application ever been evicted, broken a lease contract or been sued for damages or non-payment of rent? □ Yes □ No

Explain ______

VEHICLE INFORMATION

Make: Model: Year: License No.

Make: Model: Year: License No.

Make: Model: Year: License No.

PET INFORMATION

Breed: Age: Weight: Vaccines:

Breed: Age: Weight: Vaccines:

BANK AND CREDIT REFERENCES:

Bank Name: City: State: ______

Credit Card: City: State: ______

PERSONAL REFERENCE:

Name: Phone: Relationship:

CRIMINAL BACKGROUND

1. Have anyone listed on this application ever been convicted of or plead guilty or “no contest” to a felony (whether or not resulting in a conviction)? ? Yes ? No

2. Have anyone listed on this application ever been convicted of or plead guilty or “no contest” to a misdemeanor involving violence or sexual misconduct

(Whether or not resulting in conviction)? ? Yes ? No

EMERGENCY CONTACT INFORMATION:

In case of emergency, Notify: Relationship: ______

Phone#: (__) ______E-Mail:______

Acknowledgment

I certify all of the above information is true and complete. I authorize Management to use reasonable and necessary means to verify any of the above and

procure such other information which may be required to evaluate this application, including, but not limited to an investigation of my credit, criminal

background, employment history and previous rental history.

Signature of Applicant: Date:______

“Equal Housing Opportunity”

OFFICE USE ONLY

Income Percentage: Size of Unit Desired:

Landlord Verification: Unit Number Shown:

Phone I.D. Obtained: Move-In Date: