Westernmp Housing Rental Application Page 3
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REFERENCES
Family _____________________________________________________________________________________________
Full Name
Relationship
___________________________________________________________________________________________________
City
State
Zip
Phone#
Emergency Contact __________________________________________________________________________________
Full Name
Relationship
Phone #
MISCELLANEOUS INFORMATION
Do you have an animal?
Check one
Yes
( )
No ( )
If yes, what kind of animal? _____________________________________________________________________________
Water-Filled Furniture _________________________________________________________________________________
Description
Number
Automobiles/Motorcycles to be parked on premises:
___________________________________________________________________________________________________
Make
Model
Year
License #
___________________________________________________________________________________________________
Make
Model
Year
License #
Have you ever been delinquent in payment of your rent or any other financial obligation? If yes, please explain:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Have you ever been a defendant in an unlawful detainer (eviction) lawsuit or defaulted (failed to perform) any obligation of a
Rental agreement or lease? If yes, please explain:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
APARTMENT RESERVATION AGREEMENT
Apartment # _____________ Property Address _____________________________________________________________
Street
City
State
Zip
Monthly Rental: $ _________________________________ Lease Term: ________________________________________
The undersigned has paid Western Management Properties, the sum of $ ________________________________________
($
) as a deposit in connection with this application. The deposit shall be used and applied in the
following order:
a.
$ ______________________ constitutes a non-refundable fee for processing a credit check.
b.
$ ______________________ shall be applied towards the Security Deposit upon approval of this application. If the
application is not approved from any reason, this portion of the application deposit shall be refunded.
c.
Once applicant deposits money to hold an apartment, the apartment is taken off the market and is held in good faith for the
applicant. Applicant has three business days to change his/her mind and to receive a full refund of the application deposit.
After three business days, Western Management Properties shall retain the entire security deposit.
The information on this application is true and correct to the best of my knowledge. I hereby authorize Western
Management Properties/Valva Realty or its agents to verify the above information and to obtain either a consumer
$30.00 fee
or investigative credit report. I understand that the
for verifying this rental application is not a deposit
or rent and will not be applied to future rent or refunded, even if this application to rent is denied.
Note: ALL APPLICANTS MUST SIGN BELOW (18 years of age or older).
Signature _______________________________________________________ Date ___________________________
(Applicant Signature)
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