Rental Application - Thalhimer Apartments Page 2
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1
2
3RENTAL APPLICATION
Page 2 of 2
OCCUPANT DATA
Include children’s names & ages as well as any other authorized occupants.
Occupant Name:
Occupant Name:
AGE:
AGE:
Occupant Name:
Occupant Name:
AGE:
AGE:
Occupant Name:
Occupant Name:
AGE:
AGE:
□
□
Will any person occupying the premises require a visual smoke detector for the hearing impaired?
Yes
No
PET INFORMATION
Type of pet:
Breed:
Color:
Name:
Type of pet:
Breed:
Color:
Name:
EMERGENCY CONTACT
Nearest relative not currently living with you.
Name (s):
Relationship:
Address:
STREET
CITY
STATE / ZIP
Phone/Day: (
)
Phone/Evening: (
)
I certify that the facts set forth in the RENTAL APPLICATION are true and complete to the best of my knowledge and belief. I understand that making a known false statement
on this application is grounds for denial, termination of lease and/or eviction. I consent that the information provided above may be verified, and I further authorize the owner
to make any investigation of my residential history, employment history, and credit/financial references. All such information hereon will be kept confidential.
I agree that the required Application Fee of $
received by management on
will not be refunded for any reason. I further agree that my
Holding Fee/Application Deposit received by management ($
given on
) will be applied toward the Security Deposit, which must be paid in
full before occupancy and may not be applied as rent; the first month’s rent must also be paid before occupying an apartment. If I decide not to move in after this RENTAL
APPLICATION has been accepted, I agree that the Holding Fee/Application Deposit will not be refunded. If I feel that my RENTAL APPLICATION has been unfairly denied, I
understand that I have the right to call the Property Manager at (804) 646-5881 to request additional consideration. I understand that this is an application only, and I acquire no
rights in any apartment until: 1) said application is approved, 2) I pay the required deposit, and 3) I sign a Lease Agreement. At that time, this application becomes part of the lease.
APPLICANT’S SIGNATURE:
DATE:
It is our policy to rent to qualified persons regardless of race, color, religion, sex, national origin, handicap, familial status, or elderliness (VA only) in compliance with all federal, state and local laws.
Approved:
Denied:
Processed By:
Date:
+
+
+
=
TOTAL RENT =
Base Rent ($
)
Pet ($
)
W/D ($
)
Misc. Other ($
)
$
(Total Monthly Recurring Charges)
INITIAL MOVE-IN DEPOSITS AND FEES
PRORATED MOVE-IN CHARGES
Rent
Move In
Specials
*Please note check
with CK#, money
Credit Fee
Security
Pet
Fumigation
Base Rent
Pet
Wash/Dry
Other
order with MO#,
(zw)
Deposit
Deposit
Fee (19)
(01)
(09)
(22)
or cash receipt#
Free W/D
S/D Special
Other
Total Charge
*Method of Payment
Amount Paid
Date Paid
Date Process/
Deposited
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