Virginia Lease Application - Camden Hills Apartments

VIRGINIA

LEASE APPLICATION

(Please Print)

Received ____________________________________________

Date _______________________________________________

Processed ___________________________________________

Property ___________________________________________

App/Deny ___________________________________________

Consultant _________________________________________

Notified _____________________________________________

Concession _________________________________________

Additional Deposit ____________________________________

Applicant Name: _______________________________________

Date of Birth: _____________________________________

Social Security #: _______________________________________

Driver’s License #: _________________________________

Passport/Alien #: _______________________________________

State: ___________________________________________

Current Employer: _____________________________________

Phone: __________________________________________

Address: ______________________________________________

Time Employed: __________________________________

_____________________________________________________

Annual Salary: ____________________________________

Position: ______________________________________________

Supervisor’s Name: ________________________________

Previous Employer: ____________________________________

Phone: __________________________________________

Address: ______________________________________________

Time Employed: __________________________________

_____________________________________________________

Annual Salary: ____________________________________

Position: ______________________________________________

Supervisor’s Name: ________________________________

Military Rank: _________________________________________

Serial #: _________________________________________

Commanding Officer: ___________________________________

Time In: _________________________________________

Other Income Source: ___________________________________

Amount: _________________________________________

Current Address: _______________________________________

Phone: __________________________________________

(If military, home of record) ______________________________

Monthly Payment: _________________________________

Dates of Residency From: ________________________________

To: _____________________________________________

Landlord/Mortgagee: ___________________________________

Phone: __________________________________________

Previous Address: ______________________________________

Phone: __________________________________________

_____________________________________________________

Monthly Payment: _________________________________

Dates of Residency From: ________________________________

To: _____________________________________________

Landlord/Mortgagee: ___________________________________

Phone: __________________________________________

Checking Account #: ____________________________________

Savings Account #: ________________________________

Bank: ______________________________________________

Bank: _________________________________________

Branch: _____________________________________________

Branch: ________________________________________

# Automobiles__________

Make: _____________________ Model: _______________________ Year: __________ Tag/State: ____________________

Make: _____________________ Model: _______________________ Year: __________ Tag/State: ____________________

# Occupants (including self )_______ All occupants 18 years of age of older must complete an application.

Other Occupants

Name: _________________________________ Age: _______

Relation: _________________________

Name: _________________________________ Age: _______

Relation: _________________________

Name: _________________________________ Age: _______

Relation: _________________________

# Pets____

_____________________________________________________________

Description (breed, size, color, weight)

_____________________________________________________________

Description (breed, size, color, weight)

Emergency Contact Information

Name: _______________________________________________

Address: _________________________________________

Phone #: ___________________________________________________

Alternate Phone #: ______________________________________

Have you or any occupant of your household at any time and in any place ever been charged with, arrested for, or convicted of a criminal offense?

YES_________

NO__________

If the answer to the previous question is yes, state the date, place and nature of the criminal offense for which you or your occupant were charged, arrested or

convicted and state the outcome of that charge, arrest or conviction:

I (We) hereby deposit $__________ with Management as a good faith deposit in connection with this rental application. If my application is accepted I understand this deposit will be

applied toward my Leasing/Administrative Fee of $__________(NON-REFUNDABLE). If Management accepts my application, I agree to execute the attached rental agreement on or

before the occupancy dates set out in this application. I acknowledge that my application will be deemed withdrawn and I will not be entitled to possession of the apartment if I fail

to so execute and deliver the rental agreement. If for any reason Management decides to decline my application, then Management will refund this good faith deposit to me if full. I

understand the Application Fee of $___________ is NON-REFUNDABLE.

I hereby authorize the release of any and all information concerning my (our) credit, employment, rental and/or mortgage history and loan verification as requested by Management

in connection with my (our) application for renting an apartment home. A photographic copy of this authorization (being a valid copy of the signature(s) of the undersigned) may be

deemed to the equivalent of the original and may be used as a duplicate original. The above current information will be requested for the use of the bona fide “permissible purpose”

as defined in section 604 of Public Law 91-508.

This application shall not be binding upon the owner until accepted in writing. The delivery of a lease to the undersigned for signature shall not be construed as an acceptance of this

application nor shall such lease be binding upon the owner until it has been executed on the owner’s behalf and delivered to the undersigned.

I hereby authorize The Donaldson Group to obtain any and all credit reports, credit records, credit applications, financial records and any and all other records relating to my past credit history,

including any and all information contained in said records. This Authorization shall permit the obtaining and disclosure of any and all reports or records or information developed or reported

to or by credit reporting agencies, credit providers, and any other person or entity who collects, keeps or disseminates credit or financial or personal information, including but not limited to

Equifax International, Inc., TRW or CBI.

In addition, I hereby authorize The Donaldson Group to obtain any and all criminal history reports, criminal conviction records, criminal arrest records and any and all other records relating to my

past or present history regarding any alleged or actual criminal activity or absence thereof. This Authorization shall also permit disclosure of any and all records relating to any past or present

history regarding any alleged or actual criminal activity including arrests, summonses, charges, indictments, convictions, acquittals or the absence thereof by any criminal record reporting

company and any other person or entity who collects, keeps or disseminates said criminal history information, including but not limited to First Advantage SafeRent.

Photocopies or reproductions of sufficient quality to be deemed the substantial equivalent of the originals of the above-described information shall be disclosed, at their request, to The

Donaldson Group’s agents and representatives.

Applicant’s Signature: _______________________________________________________________________ Date: ______________

Earnest Money Dep. Paid: ___________________

Check #: _______________

Other: _________________ Date: _______________

Application Fee Paid: ______________________

Check #: _______________

Other: _________________ Date: _______________

Apartment # Held: ________________________

Rent Amt. _____________

Unit Type: ______________ Move In: ____________