RENTAL AND OWNERSHIP APPLICATION- PRINT CLEARLY copy this or use another sheet of paper if more space is necessary

New home address desired: Available move in date:

Applicant Name : ss# driver/id #
AKA including maiden marital status dob
cell Phone other phones email
Co-Applicant Name : ss# driver/id #
AKA including maiden marital status dob
cell Phone other phones email

other proposed residents/dob/relationship:

home address dates of residency (to/from) rent amt

landlord name/address tele#
previous home address dates of residency (to/from) rent amt
why move? give notice? Y / N current on payment? Y / N
landlord name/address tele#

Applicant employer: supervisor tele#

address job dates employed (to/from) gross pay $ hr/mo
Applicant prev. employer: supervisor tele#
address job dates employed (to/from) gross pay $ hr/mo
other income source amount $
Co-applicant employer: supervisor tele#
address job dates employed (to/from) gross pay $ hr/mo
Co-applicant prev. employer: supervisor tele#
address job dates employed (to/from) gross pay $ hr/mo
other income source amount $

CREDIT REFERENCES: A- APPLICANT C- CO-APPLICANT B- BOTH

loan or type name/addr/tele act # amt owed:
loan or type name/addr/tele act # amt owed:
loan or type name/addr/tele act # amt owed:
checking/ savings accounts: institution: balance:
checking/ savings accounts: institution: balance:
credit card name/addr/tele amt owed:
credit card name/addr/tele amt owed:

PERSONAL REFERENCES AND EMERGENCY CONTACTS: A- APPLICANT C- CO-APPLICANT B- BOTH

name address related? tele#
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Vehicles: type year make model color lic. # state

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Additional information:
Have you ever willingly refused to pay rent? Y / N if Yes to whom and why?
Have you ever been served notice to evict or been evicted? Y / N if Yes from where and why?
Have you had reoccurring problems with your current rental unit or landlord? Y / N if Yes please explain.
why are you moving?
Have you ever filed for bankruptcy? Y / N if Yes when, explain
Have you ever been arrested OR convicted of a crime? Y / N if Yes: where, when and for what charge(s)

I believe that the statements I have made are true and correct. I herby authorize a credit and/or criminal check to be made, verification of informa-
tion may result in the rejection of this application. I understand that this is an application for a rental unit and does not constitute a rental, lease or
purchase agreement in whole or part. I further understand that there is a non-refundable fee of $27.00 to cover the cost of processing my application
and I am not entitled to a refund even if I don't get the unit I am applying for. In addition any deposits submitted with my application will be credit-
ed towards the Security Deposit and are non-refundable once my application is approved. Deposits submitted on 'denied' applications will be
returned within 7 business days. Any questions regarding rejected applications must be submitted in writing and accompanied by a self-addressed
stamped envelope. The applicant(s) recognizes that information may be obtained from bureaus, landlords, employers, public record and interviews.
This application may be disapproved as a result of any misrepresentation or insufficient information as a result of an incomplete application.

________________________________________
_________ ________________________________________
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Applicant Signature Date Co-Applicant Signature Date
(Bring With You: 1.) application 2.) photocopy of all applicants': sdriver license/ state ID, ssocial Sec. card, spaystubs 3.) money order or cash for $27.00/each application)