Winter Park Pointe

Eudora Grove II Apartments

Application for residency

3001 Northland Road Ste. 109

Mount Dora, FL 32757 Unmarried CO-Applicants-Please use Separate Application

Phone (352) 735-0200 Fax (352) 735-2114 Unit Requested: ______

Apartment Desired: No. of Bedrooms / Baths: _____/______; Desired Move in Date: ______; Total Occupants: ______

Applicant Name:______

Last First MI. (Former)

Social Security No: ______; Date of Birth: ______

Drivers License No: ______; State:______; Expiration Date:______

Phone #:______Cell #:______Email Address:

Spouse Name:______

Last First MI. (Former)

Social Security No: ______; Date of Birth: ______Phone:

Drivers License No: ______; State:______; Expiration Date:______

List Occupants That Will be Living in the Apartment: – (PETS NOT PERMITTED without Written Authorization)

Name: ______; Soc. Sec. #: ______; Date of Birth:______; Relation:______

Present Address: Lease Apartment:______; Lease Home: ______; Own Home:______; (Check One)

Street Address:______

City: ______; State:______; Zip Code: ______

Landlord / Mortgage Co. Name: ______; Phone No:______

Street Address:______; City:______; State:______; Zip Code:______

Date of Occupancy - To: ______; From:______; Monthly Payment Amount: ______

Reason for Moving: ______

Name on Lease / Mortgage: ______

Previous Address: Lease Apartment:______; Lease Home: ______; Own Home:______; (Check One)

Street Address:______

City: ______; State:______; Zip Code: ______

Landlord / Mortgage Co. Name: ______; Phone No:______

Street Address:______; City:______; State:______; Zip Code:______

Date of Occupancy - To: ______; From:______; Monthly Payment Amount: ______

Reason for Moving: ______

Name on Lease / Mortgage: ______

Applicant Employment: Full Time:____ ; Part Time:____ ; Hours Worked: ______; Unemployment: ____; Retired/Disability: ____

Employer Name:______; Phone No: ______

Street Address:______; City:______; State:______; Zip Code:______

Position: ______; Gross Monthly Income : ______; Per Hour $:______

Date of Employment - To: ______; From:______; Contact:______

Other Sources of Income (If Applicable): ______Monthly Amount: ______

Spouse Employment: Full Time:____ ; Part Time:____ ; Hours Worked: ______; Unemployment: ____; Retired/Disability: ____

Employer Name:______; Phone No: ______

Street Address:______; City:______; State:______; Zip Code:______

Position: ______; Gross Monthly Income: ______; Per Hour $:______

Date of Employment - To: ______; From:______; Contact:______

Other Sources of Income (If Applicable): ______; Monthly Amount: ______

Have you or your spouse ever left owing money to a Landlord? : Applicant: Yes____ ; No____ ; Spouse: Yes____ ; No____

Have you or your spouse ever been Evicted? : Applicant: Yes____ ; No____ ; Spouse: Yes____ ; No____

Have you or your spouse ever applied to Palm River Apts. before? : Applicant: Yes____ ; No____ ; Spouse: Yes____ ; No____

Do either you or your spouse have any Felony Convictions? : Applicant: Yes____; No____; Spouse: Yes____; No____

** If you checked ‘yes’ to any of the above questions, please explain the circumstances below.

Emergency Contact: ______, ______, ______Last First Relation

Street Address: ______

City: ______; State: ______; Zip Code: ______

Phone No: ______Phone No: ______

Vehicle Information:

Year: ____; Make______; Model: ______; Color: ______; License Plate No. & State: ______

Applicant(s) has deposited a holding Fee in the amount of $ 150.00 in consideration for taking an apartment off the market while waiting for approval of this Application. Applicant(s) have 1-day from the date of this Application to inform Owner or Owner’s Agent in writing of Applicant(s) intention NOT to rent the apartment. If Applicant(s) fails to inform Owner or Owner’s Agent in writing within 1-day of this Application of Applicant(s) intention NOT to rent the apartment, then Applicant(s) Shall forfeit the Holding Fee and both parties shall be released from all obligations of this Application.

If Application is approved, the Holding Fee will be applied towards the Security Deposit at the time of move in. If Application is denied Owner will refund the Applicant(s) Holding Fee and both parties shall be released from all obligations of this Application.

AUTHORIZATION OF RELEASE OF INFORMATION: Applicant(s) represent(s) that all above information and statements are true and complete, and hereby authorize(s) verification of any and all information relating to residential history (rental mortgage), employment history, felony conviction records and credit records. Applicant(s) hereby acknowledge(s) that false or omitted information herein may constitute grounds for rejection of this Application, termination of right of occupancy, and / or forfeiture of fee(s) or deposit(s), and may constitute a criminal offense under the laws of the State of Florida. Applicant(s) agree(s) to pay a non-refundable Application fee of $35.00 per individual application. Applicant(s) agree(s) to Eudora Grove II Apartments APPLICATION Process, and CREDIT POLICY. This Application is preliminary only, and does not obligate Owner or Owner’s Agent to execute a Lease Agreement or deliver possession of the proposed Premises. No Oral Agreements have been made. Eudora Grove II Apartments is a Fair Housing Opportunity Rental Community.

______Date: ______Date: ______

Applicant Signature Applicant Signature

______Date:______

Owner/Agent Signature