Rental Application Conventional Page 2

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OTHER OCCUPANTS (list all persons not signing this Application who will be listed on the lease)
___________________________________________________________________________________________________________
Name
Social Security Number
Relationship to Applicant
________________________________________________________________________________________________M / F ______
Date of Birth
Drivers License No. and State OR Govt. Issued Photo ID No.
Sex
___________________________________________________________________________________________________________
Name
Social Security Number
Relationship to Applicant
________________________________________________________________________________________________M / F ______
Date of Birth
Drivers License No. and State OR Govt. Issued Photo ID No.
Sex
___________________________________________________________________________________________________________
Name
Social Security Number
Relationship to Applicant
________________________________________________________________________________________________M / F ______
Date of Birth
Drivers License No. and State OR Govt. Issued Photo ID No.
Sex
ANIMALS
Do you or any other prospective resident or occupant have an animal?
Yes
No
If yes, please list:
___________________________________________________________________________________________________________
Type
Breed
Weight
Color
Age
Name
___________________________________________________________________________________________________________
Type
Breed
Weight
Color
Age
Name
YOUR VEHICLE(S) If Applicant will be parking a vehicle on the property, please provide the following information:
___________________________________________________________________________________________________________
Vehicle Type (car, motorcycle, truck)
Make of Vehicle
Model
Year
State/License Plate No.
___________________________________________________________________________________________________________
Vehicle Type (car, motorcycle, truck)
Make of Vehicle
Model
Year
State/License Plate No.
EMERGENCY In case of emergency, notify (preferably a relative over the age of 18 years):
___________________________________________________________________________________________________________
Name
Relationship
Address
Home Phone No.
Work Phone No.
In the event that the Applicant becomes a resident in Owner’s apartment community, Applicant’s execution of this Application shall authorize
the Owner, in the event of the Applicant’s death to: (i) grant to the person designated above access to the Applicant’s unit at a reasonable
time and in the presence of the Owner or the Owner’s agent; (ii) allow this person to remove any of the Applicant’s property or any other
contents found in the Applicant’s unit or any of Applicant’s property located in the mailbox, storerooms or common areas; and (iii) refund the
Applicant’s security deposit, less lawful deductions, to this person. Applicant also authorizes the Owner to allow this person access to remove
all contents of the unit as well as property in the mailbox, storerooms and common areas in the event that Applicant becomes seriously ill.
AUTHORIZATION: Applicant represents that all of the above information is true and complete and authorizes the verification of same
and the performance of a credit check on Applicant as appropriate by all available means. In the event that Applicant provides any
false or misleading information in this Application, Owner shall have the right to automatically reject this Application and the Application
Deposit and Administrative Fee will be automatically forfeited by the Applicant. Applicant further acknowledges that an investigative
consumer report includes information as to character, general reputation, personal characteristics, and mode of living, whichever are
applicable, of the Application may be made and that any person on which an investigative consumer report will be made has the right
to request a complete and accurate disclosure of the nature and scope of the investigation requested and also has the right to request a
written summary of the person’s right under The Fair Credit Reporting Act. Applicant hereby authorizes the Owner or the
Owner’s Agent to obtain and hereby instructs any consumer reporting agency designated by Owner or Owner’s Agent to
furnish a consumer report under The Fair Credit Reporting Act to Owner or Owner’s Agent to use such consumer report in
attempting to collect any amount due and owing under this Application, the Applicant’s lease (to be executed after
Application approval) or for any other permissible purpose.
APPLICATION DEPOSIT AND NON-REFUNDABLE FEES:
Simultaneously with the execution of this Application, Applicant has paid:
Application Deposit (the “Application Deposit”) (if applicable) $
Check Number
____________
Non-Refundable Application Fee (if applicable)
$
Check Number
____________
Administrative Fee (if applicable)
$
Check Number
____________
Total
$
Applicant acknowledges that Owner's acceptance of Applicant as a resident at the property is conditional upon: (i) Owner's approval of this
Application; and (ii) receipt of an executed Apartment Lease Agreement from Applicant. In the event any of these conditions have not been
met, Owner shall have no obligation to lease to Applicant.
The Application Deposit is not considered a security deposit under this Application or applicable law. The Application Deposit will either be:
(i) credited to the required security deposit pursuant to an Apartment Lease Agreement executed by Applicant; (ii) refunded to Applicant as
provided herein; or (iii) retained by Owner as liquidated damages as provided herein.
Application Deposit Credited to Security Deposit
In the event that this Application is approved by Owner and Applicant meets all other conditions of occupancy, executes an Apartment Lease
Agreement with Owner as and when required by Owner, the Application Deposit shall be credited towards the security deposit identified in
the Lease.
Application Deposit Refunded and Administrative Fee Returned
If this Application is denied, the Application Deposit and Administrative Fee will be refunded to Applicant within 30 days of submitting
application.
Application Deposit and Administrative Fee Retained by Owner
Owner shall be entitled to retain the Application Deposit and Administrative Fee as liquidated damages; in which case, all further obligations
to lease the premises to Applicant shall be terminated if: (i) the Application is withdrawn, for any reason, after signing this Application; or (ii)
the Application is accepted, but Applicant does not sign an Apartment Lease Agreement as and when required by Owner; or (iii) if the
Applicant has provided false or misleading information within this Application. For the purposes of this provision, if the Applicant is required
to pay an additional Application Deposit in order to qualify for occupancy, the Application shall be deemed conditionally accepted prior to the
payment of such additional Application Deposit and the failure to pay the additional Application Deposit will entitle Owner to retain the
originally paid Application Deposit, even if the Application is subsequently rejected by the Applicant’s failure to pay the required additional
Application Deposit.
Dated effective on the date Owner or Owner’s representative has received a completed Application from Applicant, as indicated above.
OWNER:
APPLICANT:
_________ APARTMENTS
Signature:
__
Signature: _________________________________________
Name Printed: _____________________________________
Name Printed:
__
_
_
Date:
__
Date: _____________________________________________
2
Riverstone Residential Group Rental Application
Revised January 2010

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