Apartment Community:

Individual Rental Applications are required from each applicant 18 years of age or older. ALL SECTIONS MUST BE COMPLETED.

It is important that all information on this and all other forms related to your Application is complete and correct. False, incomplete or misleading information may cause your Application to be denied. Your Application will be processed in accordance with our RESIDENT SELECTION CRITERIA, available in the Rental Office.

Your Legal
Name:
Last / First / M.I. / Drivers License # / I.D. # / State
Have you ever been known by any other name? Yes No If Yes, what?

Please provide ALL addresses for at least the past 3 years. Do NOT include P.O. Boxes. Attach additional pages if necessary.

CURRENT ADDRESS:

Street Address / Apt. # / City / State / Zip
Home Area Code/Phone Number / Work Area Code/Phone Number / Cell Area Code/Phone Number
Current Landlord/Owner Name / Landlord/Owner Address (Street/City/State/Zip) / Landlord Area Code/Phone No.
Monthly Rent / Move-in Date / Why are you moving?

FORMER ADDRESS:

Street Address / Apt. # / City / State / Zip
Former Landlord/Owner Name / Landlord/Owner Address (Street/City/State/Zip) / Landlord Area Code/Phone No.
Move-in Date / Move-out Date / Why did you move?

FORMER ADDRESS:

Street Address / Apt. # / City / State / Zip
Former Landlord/Owner Name / Landlord/Owner Address (Street/City/State/Zip) / Landlord Area Code/Phone No.
Move-in Date / Move-out Date / Why did you move?
If you answer Yes to any of the following questions, please provide details. Attach additional pages of explanation, if necessary.
1. / Have you been evicted or served with a notice to vacate within the last 3 years? Yes No If Yes, provide reason and address:
2. / Are you a current user of any illegal drug or controlled substance? Yes No If Yes, explain:
3. / Have you ever been convicted of a felony or misdemeanor? Yes No If Yes, explain:
4. / If you answered Yes to question 3, have you successfully completed & been released from a recognized rehabilitation program,
AND remained crime-free? Yes No If Yes, when?
5. / Will any other person(s) live in the household on a fulltime or part time basis? Yes No If Yes, who?
6. / Do you own a pet? Yes No If Yes, describe:
7. / Do you own a waterbed, other liquid-filled furniture or aquarium that exceeds 25 gallons? Yes No If Yes, describe:
Do you have damage insurance? Yes No If Yes, provide the name and address of the
insurance company:

HOUSEHOLD COMPOSITION:

List ALL persons, including yourself, who will live in the household.

# / Full Legal Name
(First, MI & Last) / Date of Birth / Social Security Number / Occupation
1.
2.
3.
4.
5.
6.
7.

MARKETING INFORMATION:

How did you hear about us? / Referral from Resident/Resident’s Name:
Newspaper/Name: / Website: / Drive-By
Apartment Rental Publication: / Other:

INCOME:

Employment /
Source of Income / Address of Employment or Source
(Street/City/State & Zip) / Area Code/Phone No. / Name of Payroll or Other Contact / Gross Monthly Income
$
$
$

VEHICLES:

List ALL motor vehicles (including motorcycles) that you plan to park at the Apartment Community.

Make/Model / Year / Registered To / License Plate # / Color(s)
Make/Model / Year / Registered To / License Plate # / Color(s)

EMERGENCY CONTACT:

Please list two persons who know how to contact you, and who we may contact in case of an emergency:

Contact Name / Contact Address (Street/City/State/Zip) / Contact Area Code/Phone No.
Contact Name / Contact Address (Street/City/State/Zip) / Contact Area Code/Phone No.
APPLICANT CERTIFICATION
I certify that all information given on this Application and any additional attachments are true, complete and accurate. I understand that if any of the information I provide is false, misleading or incomplete, Agent for Owner may deny my Application, or if move-in occurs, terminate my Lease. I authorize Agent for Owner to make any and all inquiries to verify the information either directly or through information exchanged now or later, and to contact sources for verification and/or confirmation. I consent to allow Agent for Owner to disclose my tenancy information to previous or subsequent Owner/Agents. If my Application is approved and move-in occurs, I certify that only those persons listed on this Application will occupy the apartment. I agree to notify Agent for Owner regarding any changes in my household composition. ADDITIONALLY, I UNDERSTAND THAT MISREPRESENTATION COULD RESULT IN AN AUTOMATIC DENIAL OF MY APPLICATION OR TERMINATION OF MY TENANCY.
Applicant Signature / Date
COMPLETED BY AGENT FOR OWNER
Received By: / Date Received:

35-F/04-07(C)