Tower Realty LLC

Tower Realty LLC

RENTAL APPLICATION

DESIRED APARTMENT

Address: ______

Desired Date of Occupancy______Desired Length of Occupancy______

How did you hear about this apartment?______

APPLICANT INFORMATION

Name ______Social Security #______

Phone______Alternate Phone______Date of Birth______

Email Address (Self)______License Number______License State_____

If student, current school year (circle one):SophmoreJunior Senior Years left?_____

EMERGENCY CONTACT (or If student, enter Parents’ Names and Address)

Name ______Address______City______State_____

Email Address ______Phone______Relationship______

PRESENT ADDRESS (If student, enter Campus/Local address)

Present Address______City______State______

Landlord Name ______Phone______Monthly Rent______

How Long at this address?______Why are you moving?______

May We Contact Landlord? Yes No Are you breaking lease?Yes No

Have you been asked to leave? Yes No If Yes, Why? ______

PREVIOUS ADDRESS (If student, enter permanent address if different than above parents' address)

Previous Address______

Landlord Name ______Phone______Monthly Rent______

How Long at this address?______Why are you moving?______

May We Contact Landlord? Yes No Are you breaking lease?Yes No

Have you been asked to leave? Yes No If Yes, Why? ______

CURRENT EMPLOYER

Company Name ______Address______Phone______

Supervisor ______Length of Employment______Position______

Weekly Take-home Pay?______

PREVIOUS EMPLOYER

Company Name ______Address______Phone______

Supervisor ______Length of Employment______Position______

Weekly Take-home Pay?______

REFERENCES (Two Required. Cannot be your immediate family.)

Name ______Address______Phone ______Relationship_____

VEHICLE INFORMATION

Make ______Model______Color______License Plate# ______State______

OTHER PERSONS TO OCCUPY THE APARTMENT

Name ______Phone______Relationship______

APPLICANT QUESTIONAIRE

How will you pay the monthly rent(Please check all that apply)? wages/salary Parentsgov't assistance/loans

Student Loansother (please specify)

Have you ever been evicted from any tenancy? Yes No

Have you ever willfully and intentionally refused to pay rent when due? Yes No

Have you ever been locked out of your apartment by the sheriff? Yes No

Have you ever moved owing rent or damaged an apartment? Yes No

Have you ever been bankrupt? Yes No

Have you ever broken a lease? Yes No

Have you ever beenguilty of a felony? Yes No

Have you ever been sued for bills? Yes No

Do you know of anything that may interrupt your income or ability to pay rent, including DELAYS IN APPROVAL AND RECEIPT OF STUDENT LOANS? Yes NoIf yes, please explain:______

Is the total security deposit and first month rent available now? Yes No If No, When?

Is your rent fully paid at this time? Yes No

Have you ever been late making any payments? Yes No

Please answer the following: If your guest broke a window in your apartment, what would you

do?______

I hereby authorize the landlord to contact past/present landlords, employers, creditors, credit bureaus, neighbors and any other sources deemed necessary to investigate applicant. All information is true, accurate and complete to the best of my knowledge. I understand that any false answers or statements made by me will be sufficient grounds for eviction or disqualify me for potential tenancy.I understand that ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR PHOTOCOPY OF THIS FORM AT ANY TIME.

Signature______Date______

TOWER REALTY LLC

PO Box 198, Fishkill, NY 12524

Phone: 845-345-2339