River Mill Property Management

RIVER MILL PROPERTY MANAGEMENT, INC.

5321 Heather Lane, College Park, GA 30349

(770)909-8134 (770)909-4275 fax

RENTAL APPLICATION

THIS APPLICATION MUST BE COMPLETED IN FULL. ALL INFORMATION IS SUBJECT TO VERIFICATION. FALSIFIED INFORMATION WILL BE GROUNDS FOR TERMINATNG THIS APPLICATION. APPLICATION FEE IS NON-REFUNDABLE. $35 FOR SINGLE OR $60 FOR COUPLE. PAYMENT MUST BE MADE IN CASH OR MONEY ORDER.

1.HEAD OF HOUSEHOLDSPOUSE/ROOMMATE/SECOND LESSEE

______

Last name, first, middleLast name, first, middle

______

Date of birth Home phoneDate of birth Home phone

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Cell phone EmailCell phoneEmail

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Driver’s license # StateDriver’s license # State

______Sex______Sex_____

Social Security # Social Security #

National Origin: black______white______National Origin: black______white______

Hispanic_____Asian_____other______Hispanic_____Asian_____other______

2.PRESENT ADDRESSPRESENT ADDRESS

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Apartment or complex nameApartment or complex name

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Street AddressStreet Address

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City, State Zip CodeCity, State Zip Code

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Landlord Name & Phone #Landlord Name & Phone #

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Landlord AddressLandlord Address

______

Current Rent PaidCurrent Rent Paid

______

How long at this address?How long at this address?

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3. List FORMER ADDRESSES beginning with most recent for past three years.

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Apartment or Complex NameApartment or Complex Name

______

Landlord Name & Phone #Landlord Name & Phone #

______

Street AddressStreet Address

______

City, State Zip CodeCity, State Zip Code

From______To______From______To______

Month/ToMonth/ToMonth/To Month/To

______

Apartment or Complex NameApartment or Complex Name

______

Landlord Name & Phone #Landlord Name & Phone #

______

Street AddressStreet Address

______

City, State Zip CodeCity, State Zip Code

From______To______From______To______

Month/ToMonth/ToMonth/To Month/To

______

Apartment or Complex NameApartment or Complex Name

______

Landlord Name & Phone #Landlord Name & Phone #

______

Street AddressStreet Address

______

City, State Zip CodeCity, State Zip Code

From______To______From______To______

Month/ToMonth/ToMonth/To Month/To

PAGE THREE

______

Apartment or Complex NameApartment or Complex Name

______

Landlord Name & Phone No.Landlord Name & Phone No.

______

Street AddressStreet Address

______

City, State Zip CodeCity, State Zip Code

From______To______From______To______

Month/ToMonth/ToMonth/To Month/To

4. FINANCIAL INFORMATION

Bank Name______Address______Phone______

Type of account______Acct. #______

Bank Name______Address______Phone______

Type of account______Acct. #______

Bank Name______Address______Phone______

Type of account______Acct. #______

4. PLACES OF EMPLOYMENT

A.Head of household –

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Company NameAddress

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Phone # Immediate Supervisor

______per______

How long Salary hour/week/month

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B.Spouse/roommate/etc. employment

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Company NameAddress

______

Phone # Immediate Supervisor

______per______

How long Salary hour/week/month

5. PERSONAL REFERENCES {Please list three (3)}

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a. NamePhone #

______

Street AddressCityState

______

Relationship to you

______

b. NamePhone #

______

Street AddressCityState

______

Relationship to you

______

c. NamePhone #

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Street AddressCityState

______

Relationship to you

6. Other persons living with you (Include all children)

Full Name______SSN#______

Date of Birth______

Full Name______SSN#______

Date of Birth______

Full Name______SSN#______

Date of Birth______

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7. EMERGENCY CONTACT

Name______Phone______

Address______Relationship______

Name______Phone______

Address______Relationship______

8. Vehicles on/to be on the property

Make______Model______Year______Tag______State______

In an effort to keep our community drug-free, it is our policy to reject any and all applicants that are current illegal drug users or those convicted of selling or manufacturing illegal drugs. We will not process an incomplete application. All questions must be answered truthfully.

9. Are you or a member of your household currently using any illegal drugs or any controlled substance that hasn't been prescribed to you? ______

10. Have you or a member or your household been convicted of the illegal manufacture and/or distribution of illegal drugs or controlled substance or any other felony?______

______

12. Have you ever been evicted?______When?______

13. Have you ever gone bankrupt?______When?______

14. Do you have pets?______What breed/how many?______

PERSONAL CHECKS WILL NOT BE ACCEPTED FOR APPLICATION FEE, SECURITY DEPOSIT OR FIRST MONTH’S RENT!!!

I acknowledge that at some time in the future, in the event that it is deemed necessary to turn this application over to the owner and/or a collection agency by signing this application I give River Mill the right to do so, with all pertinent information contained herein.

I hereby declare the above information true and correct. I am aware that the above information will be verified and that any false information will result in the termination of my lease. I further acknowledge that I will not be refunded my application fee. I, by signing this application, authorize River Mill Property Management to verify all information that I have given.

I agree to lease the unit on the terms contained in the lease agreement. I further agree that upon the cancellation of this agreement by any reason/person listed on this application, I will forfeit the entire amount of my security deposit.

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I hereby authorize River Mill Property Management and CSS Services, Inc. to receive and disclose any criminal history record or credit application information that may be in the files of CSS Services, Inc. from or to, any local, state, or criminal justice agency.

1. ______Date______

(applicant signature)

2.. ______Date______

(applicant signature)

All property will be shown, rented and otherwise made available to all persons regardless of race, color, religion, sex, handicap, national origin or family status, and to any class of person protected by state or federal law.

This application will not be processed without a current picture ID, a social security card, and the last three consecutive pay stubs.

CONSENT FORM

I hereby authorize River Mill Property Management, Inc. and CSS Service, Inc. to receive and disclose any criminal history record or credit application information that may be in the files of CSS Services, Inc. from or to, any local, state, or criminal justice agency.

I understand that my application may be declined because of information received from this record regarding past criminal history for drug-related charges, felony theft, assault or any violent crimes.

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Full printed nameFull printed name

______

Social security numberSocial security number

______

Address line 1Address line 1

______

Address line 2Address line 2

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Sex Date of BirthSexDate of Birth

National OriginNational Origin

Black____White____Hispanic____Black____White____Hispanic____

Asian____Other______Asian____Other______

______

SignatureSignature

______

DateDate