Application For Residency Page 2

- PPLIC TION FOR RESIDENCY

(Each Leaseholder must submit a separate application)

PPLIC NT INFORM TION

FULL NAME (FIRST) __________________________________________ (LAST) ______________________________________ (M.I) ________

DOB: _____________ /_____________ /_____________

SOCIAL SECURITY # _________________-________________-_______________

DRIVER’S LICENSE #: ______________________________________ STATE: _______ EMAIL: ________________________________________

PHONE # (Home) _______________________________________________ (CELL) ________________________________________________

VEHICLES:

MAKE

TYPE

COLOR

LICENSE PLATE #

STATE

YEAR

LIST OTHERS TO RESIDE IN P RTMENT ND CHILDREN WHO WILL VISIT ON

PERM NENT B SIS:

NUMBER OF ADULTS WHO WILL OCCUPY THE APARTMENT ________

NUMBER OF CHILDREN WHO WILL OCCUPY THE APARTMENT _______

FULL LEGAL NAME

RELATIONSHIP

DATE OF BIRTH

ANNUAL INCOME

OCCUPATION

PRESENT DDRESS:

STREET______________________________________________________________________________________ APT#_________________

CITY_________________________________________________________ STATE__________________________ ZIP___________________

RENT OR OWN (CIRCLE ONE)

LANDLORD/LENDER NAME: _________________________________ CONTACT PHONE #_______________________

MONTHLY PAYMENT_________ DATES (from) _______________(to)______________

PRESENT EMPLOYER:

NAME __________________________________________________ STREET____________________________________________________

CITY _______________________________ STATE _________________ ZIP _______________ PHONE _______________________________

START DATE __________________________ POSITION ___________________________________ MONTHLY SALARY____________________

SUPERVISOR OR HUMAN RESOURCES CONTACT _______________________________________________ PHONE ________________________

OTHER INCOME: SOURCE________________________________________________ GROSS ANNUAL AMOUNT_________________________

B NK CCOUNT INFORM TION:

Bank Name ____________________________________ Account Number ____________________________ Type of Account ______________

EMERGENCY CONT CT (NOT RESIDING WITH YOU):

(1) NAME________________________________________ RELATIONSHIP _______________________ PHONE # ________________________

STREET_________________________________________________ CITY__________________________ STATE ______ ZIP ______________

ARE YOU LEGALLY ELIGIBLE TO LIVE IN THE UNITED STATES: (Please check one)

❑

Yes, I am a U.S. Citizen

❑

Yes, I have provided valid documentation from the U.S. Immigration and Naturalization Service (INS) that allows me to be in the country

List source of documentation ______________________________________________ List ID# ______________________________________

If you have an Individual Tax ID #, please provide in the following space ___________________________________________________________

The undersigned applicant and/or co-signer represents that all of the above statements are true and correct and hereby authorizes verification of the above information. If such information proves to be false or mis-

leading, Owner shall have the right to deny this application. The undersigned applicant and/or co-signer hereby consents to allow the Owner, itself or through its designated agents or employees, to obtain a consumer

report, and any other information it deems necessary, for the purpose of evaluating my application. I understand that such information may include, but is not limited to, credit history, civil and criminal information,

records of arrest, rental history, employment/salary details, vehicle records, licensing records, and/or any other necessary information. The undersigned applicant or co-signer agrees and understands that Owner and

its agents and employees may obtain additional consumer reports and criminal record in the future to update or review my account. Upon my written request, Owner will tell me whether consumer reports or criminal

records were requested and the names and addresses of any consumer reporting agency that provided such reports. The undersigned applicant and/or co-signer understands that the application fee is non-refundable. If

cancellation of this application is not made by the applicant within five (5) days from the date of the signing of this application, the deposit and application fee will be forfeited by the applicant. Should this application

be denied by the landlord, then the landlord shall not be responsible for any claims or damages other than the return of the deposit.

________________________________________________________________________________________________________________

APPLICANT SIGNATURE

DATE

Community: _______________________

Monthly Rent:______________________

Security Deposit Holder (circle): Yes or No

Bldg # /Apartment #: _________________

Application Fee Collected: _____________

Co-Signor (circle): Yes or No

Unit Type: _________________________

Deposit Collected:___________________

Yardi Applicant Code: ________________

Move-in Date:______________________

Lease Date __________ to ___________

Rental Agent Name: _________________