Rental Application - Pohlig Box Factory Page 2
ADVERTISEMENT
1
2
3RENTAL APPLICATION
_______________
____________________
________________
DATE OF APPLICATION
APT SIZE DESIRED
DATE DESIRED
___________
$___________
APPLICATION FEE REQUIRED
RENT AMOUNT
UNIT ADDRESS_____________________________
: 12
LEASE TERM DESIRED
MONTH
$__________
.
A FEE OF
IS ACCEPTED AS A RESERVATION DEPOSIT
THIS DEPOSIT CAN BE RETURNED TO YOU ONLY IF THE
.
,
APPLICATION IS NOT APPROVED
UPON APPROVAL AND A SIGNED LEASE
THIS RESERVATION FEE SHALL BECOME A
.
PORTION OF THE SECURITY DEPOSIT REQUIRED BY THE LEASE
As provided by the Government Data Collection and Dissemination Practices Act, anyone who is requested to provide
personal information about him/herself must be informed whether he/she is legally required to provide such information, or
whether he/she may refuse to supply the information requested.
Although you are not legally required to provide the information requested your failure to do so will result in our inability to
determine your eligibility for housing in our development.
It is possible that information provided by you will be revealed to others for the purpose of confirmation or for other purposes
in accordance with the Virginia Freedom of Information Act, but any information so supplied is subject to the safeguards of
the Virginia Privacy Protection Act.
NAMES
_____________________________________________________ ________________ _______________________
(1)
.
LAST
FIRST
MIDDLE
DATE OF BIRTH
S OCIAL SECURITY NO
CURRENT ADDRESS
_______________________________________________________________________________
_____________
&
?
NUMBER
STREET NAME
CITY
STATE
ZIP
HOW LONG
_______________________________________________________ __________________________
____________
NAME OF APTS OR RENTAL AGENT
TELEPHONE
$ RENT RATE
PREVIOUS ADDRESS (IF CURRENT ADDRESS IS LESS THAN ONE YEAR)
_________________________________________________________________________________________________ ______________
&
?
NUMBER
STREET NAME
CITY
STATE
ZIP
HOW LONG
___________
_________________________________________________________________ ________________________________ _
NAME OF APTS OR RENTAL AGENT
TELEPHONE
$ RENT RATE
EMPLOYMENT
(1) _____________________________________________________________
_____________
________________________
CURRENT EMPLOYER
HOW LONG?
TELEPHONE
__________________________________________________________________________________________________________________
BUSINESS ADDRESS
CITY
STATE
ZIP
_____________________________________________________
__________________________
______________________
YOUR POSITION
$ SALARY
PER
_____________________________________________________ __________________________
______________________
ADDITIONAL SOURCE OF INCOME
$ AMOUNT
PER
FINANCIAL INFORMATION
______________________________________________________________ _____________________________
FINANCIAL INSTUTION
BALANCE
AUTOMOBILE
___________________________________________________________________________________________
MAKE
YEAR
COLOR
PLATE #
DESCRIPTION
___________________________________________________________________________________________
DO YOU OWN ANY RECREATIONAL VEHICLES? IF SO, PLEASE DESCRIBE
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business