Millers Apartments

Millers Apartments Application
Full Name *

First Name Middle Intial Last Name
Maiden Name if married
Birth Date *

Month Day Year
Phone Number *

- Area Code Phone Number
E-mail *
List of other proposed occupants (if children are listed, please include their ages)
Rental/Residence History

Current Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Date Residency *
Rent Amount paid *
Landlord name and phone number *
Reason for moving from current address? *
Dates of Residency *

Previous Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Rent amount paid *
Landlord name and phone number *
reason for leaving *
Employment Information
Current Employment *
Phone Number *
Occupation *
Gross monthly income *
Dates of employments *
Previous Employer *
Occupation
Gross Income *
Dates of Employment *
Other sources of income?
If you came into financial difficulty, is there sombody you can contact and help you? Name and phone number
Misc Questions
Do you have pets? *

Yes No
If yes, what kind and size? *
Does anybody smoke? *

Yes Yes, but only outside No
Has an eviction ever been filed? *

Yes No
Do you have a felony? *

Yes No
If we run a background check, will we find anything negative? *

Yes No
Is your current wages being garnished?

Yes No If yes, please list amount being deducted:
If yes, what?
Vehicle make that you own
How did you hear about Millers Apartment? *

Friend/family web search sign craigslist Facebook Other
What apartment are you interested in?
What time frame are you looking to move?
References
Full Name *

First Name Last Name
Phone Number *

- Area Code Phone Number
Full Name *

First Name Last Name
Phone Number *

- Area Code Phone Number
Everybody over the age of 18 needs to fill one out. If there is multiple applicants, please close out current window after submitting it and re-open. Social Security number will be asked if approved. Also, by submitting this application, this gives Millers Apartments approval to contact people/businesses on this application to verify information and for them to release requested information.
Should be Empty:

Millers Apartments Application

Rental/Residence History

Employment Information

Misc Questions