How did you find out about us?

Full Name _______________________________ Phone __________________ Work Phone__________________

Social Security Number _____-_____-______ Date of Birth ______________ Driver’s License # _____________

Present Address ________________________________________________________________________________

City _______________________________________ State ____________________ Zip __________________

How Long? _____________ If renting, Apartment name and location ________________________________

Landlord/mgr’s name _________________________________________________ Phone ________________

Why are you leaving? ________________________________________________________________________

___________________________________________________________________Current Rent ____________

Previous Address _______________________________________________________________________________

City _______________________________________ State ____________________ Zip __________________

How Long? _____________ If renting, Apartment name and location ________________________________

Landlord/mgr’s name _________________________________________________ Phone ________________

Why are you leaving? ________________________________________________________________________

___________________________________________________________________Previous Rent ___________

Employer _________________________________________ Position____________________ How Long?_______

Address______________________________________________________ Phone ________________________

Gross Monthly Income before deductions $________________ Other Income $____________ Source______

Former Employer __________________________________ Position____________________ How Long?_______

Address______________________________________________________ Phone________________________

Why did you leave?__________________________________________________________________________

CREDIT REFERENCES – This can include store credit cards, retail stores, car loans, small loans, etc.

Bank ______________________________Acct#(s)__________________________Branch_______________

How long ___________

Checking:[ ] Savings: [ ] Loan: [ ] City________________________ State______ Balance____________

Other Active Credit Ref:_______________________________ Account# ___________________ Exp. Date: ____

Type of Account ________________________________Credit Limit $ _______________How long ________ Are all payments current? YES [ ] NO [ ]

Other Active Credit Ref:_______________________________ Account# ___________________ Exp. Date: ____

Type of Account ________________________________Credit Limit $ _______________How long ________

Are all payments current? YES [ ] NO [ ]

Have you ever been evicted? YES [ ] NO [ ] Have you ever had a foreclosure / repossession? YES [ ] NO[ ] If yes, explain: ___________________________________________________________________________

Have you ever filed for bankruptcy? YES[ ] Date: _________ NO[ ] If yes, Chapter 7 [ ] or Chapter 13 [ ]

Explain: _____________________________________________________________________________________

Have you ever been convicted of a crime, other than a traffic violation? YES [ ] NO [ ]

If yes, explain: ______________________________________________________________________________

Name of your attorney: ____________________________________________

PERSONAL REFERENCES – List three persons, other than your relatives, that we can contact to verify your character.

Name ___________________________________Relationship________________ Phone _____________________

Address _______________________________ City________________State____________Zip_____________

Name ___________________________________Relationship________________ Phone _____________________

Address _______________________________City________________State____________Zip_____________

Name ___________________________________Relationship________________ Phone _____________________

Address _______________________________ City________________State____________Zip_____________

EMERGENCY - In an emergency you may contact (List two, other than your spouse/roommate, nearest relatives first)

Name ___________________________________Relationship________________ Phone _____________________

Address________________________________City________________State____________Zip_____________

Name ___________________________________Relationship________________ Phone _____________________

Address ______________________________ City________________State____________Zip______________

OTHER INFORMATION – Other persons (including children) who will be living in the dwelling unit.

Name ____________________________ Name ______________________________ Name ___________________

Name ____________________________ Name ______________________________ Name ___________________

Date of desired occupancy __________________ Anticipated length of stay_______________________

Do you have: Vacuum cleaner [ ]: Lawn Mower [ ]: Water Bed [ ]: Musical Instrument [ ]: Does anyone smoke? YES [ ] NO [ ]

List all motor vehicles, including recreational vehicles, to be kept at the property:

MAKE   MODEL     COLOR     YEAR     LICENSE PLATE#     STATE     MONTHLY PMT

______ _______ ________ ______ _________________ _______ __________________

______ _______ ________ ______ _________________ _______ __________________

______ _______ ________ ______ _________________ _______ __________________

A non-refundable application fee of $_______________ , earnest money of $_______________ and a deposit of$__________ Are required for processing this application, and is being paid herewith. Application Receipt must be signed by all adults who will occupy the property before it can be considered by Management. By signing this application the undersigned expressly agree to rent this unit (if application is approved) and agree that if applicant(s) are accepted by management then decide not to move into the premises, the sum of one months rent or the earnest money, will be due as liquidated damages since other prospective tenants will have been turned away and it will be necessary for Management to re-advertise the property and evaluate other applicants. If applicant is not approved, all monies given herewith, less application fee shall be returned to applicant. Processing of applicant shall be as timely as possible and the results may be offered via telephone, fax or mail.

A PHOTOSTATIC COPY OF MY DRIVER’S LICENSE OR PICTURE IDENTIFICATION CARD, SOCIAL SECURITY CARD, AND LATEST PAY CHECK STUB ARE ATTACHED TO THIS APPLICATION. I declare that the application is complete, true and correct and I give my permission for anyone to release the credit or personal information of the undersigned applicant to Management or their authorized agents solely for the purposes of entering into and continuing to offer or collect on any agreement and/or credit extended. I further authorize Management or their Authorized /Agents to verify the application information including but not limited to contacting creditors, present or former landlords, employers and personal references, whether listed herein or not, at the time of this application and at any time in the future, with regard to any agreement entered into with Management. Any false information will constitute grounds for rejection of application, or Management may immediately terminate any tenancy entered into in reliance upon misinformation given on application.

___________________________________________ ________________________ _________________

Applicant                                                                  Social Security Number         Date