TYPE OR PRINT IN BLACK INK ONLY
MIDDLE RIVER HOMES CONDO
APPLICATION FOR OCCUPANCY
NAME______SOC. SEC. #____-__-______BIRTHDATE___/___/___
(LAST) (FIRST) (M.I.)
SPOUSE______SOC. SEC. #____-__-______BIRTHDATE___/___/___
(LAST) (FIRST) (M.I.)
TOTAL NO. OFOCCUPANTS ____ NAMES & AGES OF OTHER OCCUPANTS ______
PRESENT ADDRESS ______PHONE____-____-______
St.No. Street Name Apt. No
______
City State Zip
PRESENT LANDLORD/ MORTGAGE CO.______PHONE____-____-______
ADDRESS OF LANDLORD OR MORT. CO.______
St.No. Street City State Zip
LENGTH OF MONTHLY RENT MORTGAGE
RESIDENCE YRS______MO.______OR MORTGAGE PAYMENT $______ACCT NO. ______
PREVIOUS ADDRESS ______PHONE____-____-_____
St.No. Street Name Apt. No.
______
City State Zip
PREVIOUS LANDLORD/ MORTGAGE CO.______PHONE____-____-______
ADDRESS OF LANDLORD OR MORT. CO.______
St.No. Street City State Zip
LENGTH OF MONTHLY RENT MORTGAGE
RESIDENCE YRS______MO.______OR MORTGAGE PAYMENT $______ACCT NO. ______
EMPLOYMENT
PRESENT EMPLOYER______PHONE____-____-_____
Co. Name Supervisor Name
EMPLOYER ADDRESS______
St.No. Street City State Zip
POSITION______LENGTH OF EMPLOY.____Yr____Mo INCOME______per____
PREVIOUS EMPLOYER______PHONE____-____-_____
Co. Name Supervisor Name
EMPLOYER ADDRESS______
St.No. Street City State Zip
POSITION______LENGTH OF EMPLOY.____Yr____Mo INCOME______per____
SPOUSE’S EMPLOYER______PHONE____-____-_____
Co. Name Supervisor Name
EMPLOYER ADDRESS______
St.No. Street City State Zip
POSITION______LENGTH OF EMPLOY.____Yr____Mo INCOME______per____
MIDDLE RIVER HOMES CONDO
APPLICATION FOR OCCUPANCY (CONTINUED)
BANK AND CREDIT REFERENCES
BANK NAME AND ADDRESS______CKING ACCT. NO.______
BANK NAME/CREDITOR & ADDRESS______LOAN NO.______
AUTOMOBILES AND OTHER INFO.
FIRST CAR______SECOND CAR______
YEAR MAKE MODEL TAG NO. STATE YEAR MAKE MODEL TAG NO. STATE
DRIVERS LICENSE NO.______STATE____ ADDRESS SHOWN______
IN CASE OF EMERGENCY, NOTIFY______PHONE______-______-______
ADDRESS______
STREET NO. STREET CITY STATE ZIP
NEAREST RELATIVE NOT LIVING WITH YOU______PHONE______-______-______
ADDRESS______
STREET NO. STREET CITY STATE ZIP
HAVE YOU EVER BEEN EVICTED FROM A RENTAL RESIDENCE FOR NONPAYMENT OF RENT? ______YES ______NO
IF YES, LANDLORD NAME______PHONE______-_____-______
ADDRESS______
STREET NO. STREET CITY STATE ZIP
HAVE YOU EVER BEEN CONVICTED OF A FELONY? ______YES ______NO
IF YES, PLEASE EXPLAIN (YEAR, LOCATION, TYPE OF FELONY)______
______
Applicant represents that all of the above information is true and complete and authorizes the verification of same by reasonable means. Applicant authorizes community/association to obtain applicant’s credit bureau reports and other information deemed necessary in order to process this application. Applicant understands that false or incomplete information given herein may constitute grounds for rejection of this application. Applicant agrees that a full disclosure of all information obtained may be made to the association and owner of the property for which applicant has applied.
I, The undersigned Applicant, have read and agree to all the provisions of this application.
______-_____-______
Applicant’s Signature Spouse’s Signature Date
OFFICE USE ONLY REQUEST FOR RESIDENT SCREENING SERVICES
INDICATE BY ( ) TYPE OF REPORT AND RESPONSE REQUESTED
REQUEST DATE:______FULL REPORT
MEMBER:______ECONOMY REPORT
CODE NO.______CONDO REPORT
MEMBER FAX NO. (______) ______YOUR COMPANY’S STANDARD REPORT
PERSON MAKING REQUEST:______RUSH SERVICE
APT NO:______FAX RESPONSE ONLY
MOVE-IN DATE:______VERBAL REPONSE ONLY
______VERBAL PLUS FAX RESPONSE
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