North Dakota Apaprtment Association Page 2
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1
2SECTION B
•
INFORMATION REGARDING JOINT
APPLICAN
T
(SPOUSE AND/OR
PA
RENT/GUARDIAN
ONLY
)
Full
Name:
---,,---.--
--
- -
---:-::::--,.,-----
-
--
-
-....,...,,...,-::-:----
Birthdate:
(last)
(First)
(Middle)
Present Street
Address:
-- - - - - - -
--
-
--
-
--
-
--
-- - - - - - - - - - - - - - -
City:
_ _ _ _ _ _ _ _ _
State:
_
__
Zip:
_ _ _ _ _ _
Telephone:
-
-- -
--
- - - - - -
Reason
for
Leaving:
Rent
per
month:$
Years
There:
_
_ _ _ _ _ _
__ _
Social
Security
Number:
Drivers License
Number: -
-- - -
-- - -
--
Previous Street
Address:
_
__
_ _
__
__
_
_ _ _ _ _
__
_
_
_
_
_
_
Years
There:
_ _ _ _ _ _ _
City:
_
__ _ _
__
_ _
State:
_
__
Zip:
Telephone:
-
-- - -
-- - - - - -
Reason
for
Leaving:
Rent per
month:$
_ _
Landlord
&
Telephone:--
-
--
-- - -
Present
Employer"""
:
_ _
__ _ _
__ _ _ _ _
__
Years There"'":
_ _
_____
Telephone.
" ' " : - - -
--
--
Position
or
Title:
Name
of
SupeNisor: _ _
__
_
_ _ _
__ _ _ _ _ _
_
Employer's
Address:
_
__
_
__
_
_
_ _ _ _ _
__
_ _ _ _ _ _ _
__
_
_
_ _ _
__
__ _ _
Previous
Employer:
_
__
_ _ _ _
__
_ _ _ _ _ _..;. _ _ _ _ _ _
__ _ _
Years
There
:
.
_ _
__
_ _
_
Previous Employer's
Address: _ _
__
_ _ _
__ _ _
__ _ _ _
__
_
_
__
_
_
_
__ _ _
__
_ _
Present Net Income/Month: $
_
__
_ _
__
Number of
Hours worked
:
-
-
-
--'
'
Week
_
__ _ _ _
,/
Month
Number of occupants that will be occupying
the unit:
_ _ _ _
__ _
_
NOTE:
Alimony,
child
support, or separate maintenance income need
not be revealed if
you do
not
wish
to have
it considered
as a basis
for
paying this
obligation.
Other
income:
$
per
.
Sources of other
income:
-:-:---=:--:-:---:-::-:-:--
- - , . - -
-..,.-,--
Is any
income
listed
in this section likely to be reduced in the next two years? 0
Yes
0
No
If
Yes,
please
explain:
Name of
nearest
relative not living with you:
_ _ _
__ _
__ _
__
_
_
_
Telephone: _ _ _ _ _ _ _ _ _ _
_
Relationship: _
_
_
__
_
_ _ _
__
__
.Address:
_ _
__ _ _
__
_ _ _
__
__ _ _ _
__
__
_
Present
Landlord
1.
Previous
Landlord
2.
3.
4.
5.
Automobile
Make,
Model
&
Year:
License#:
_ _ _ _ _ _ _ _
State:
_ _ _
Are you
the
co-maker and/or guarantor
of any
loan
or
contract?
0
Yes 0 No
If
Yes, to whom _ _ _ _ _ _ _ _ _ _
Are there any unsatisfied
j
udgments or
liens against
you? 0 Yes
0
No
If Yes,
to
whom.
_ _
__
_
__ _
__ _
_
Other
obligations- (i.e
.
liability
to pay alimony,
child support,
separate maintenance) Use
separate
sheet
if
necessary:
ACKNOWLEGEMENT AND AGREEMENT
For
purposes of renting,
the
undersigned acknowledges that they were informed
of
the
rental
criteria
which
was established
per
the
addendum
provided.
The
undersigned
represents that
all
of the above statements are
true
and complete and
hereby
authorizes management, its
employees and agents
to contact
and
obtain
information from any individuals or
entities that may have information
regarding
credit
history,
employment and
past
residential
arrangements
of the
undersigned.
The
undersigned
hereby
indemnify
and hold
management,
its employees and agents and all other individual or entities contracted
by
management harmless
from
all
causes
of action, expenses,
losses,
damages of
any kind arising
from or
related
to information obtained
regarding
credit
history,
em-
ployment
or
prior
residential
arrangements of the undersigned.
All
persons
will
be treated
fairly
and equally without regard to race,
color,
religion,
sex,
familial
status, handicap,
marital
status,
status
with
respect
to public assistance or
national
origin in compliance with
the
Fair
Housing
Act.
Applicant:
_
__
_ _ _ _ _ _ _
__
__ _
__
__
_ _ _ _
Date:
_
__
_ _ _
__
__ _
_
Co-A
pplicant: _
_ _ _
__ _
__ _
__ _ _ _ _ _
__ _ _
Date:
_
_ _ _ _ _
__
__ _ _
_
NOAA
Rental
Application Revised
11n001
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Parent category: Business