Application for Lease
Madison Heights Apartments
Legal Name of Primary Applicant
*
First Name
Middle Name
Last Name
Previous Legal Names
Birthdate
*
-
Month
-
Day
Year
Email
Phone Number
*
Format: (000) 000-0000.
Current Employer and Occupation
Monthly Income (Before Taxes)
*
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Legal Name of Co-Applicant (if applicable)
First Name
Middle Name
Last Name
Previous Legal Names
Birthdate
-
Month
-
Day
Year
Email
Phone Number
Format: (000) 000-0000.
Current Employer and Occupation
Monthly Income (Before Taxes)
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Additional Occupant (1)
Name, Relationship, Age
Additional Occupant (2)
Name, Relationship, Age
Additional Occupant (3)
Name, Relationship, Age
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Primary Applicant Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Long at This Address?
Current Rent or Mortgage Payment:
Current Landlord/Mortgagor Name:
Current Landlord/Mortgagor Phone Number:
Format: (000) 000-0000.
Reason for Changing Residence:
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Primary Applicant Previous Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Arrival and Departure Dates:
Previous Rent or Mortgage Payment:
Previous Landlord/Mortgagor Name:
Previous Landlord/Mortgagor Phone:
Format: (000) 000-0000.
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Date Apartment Needed:
Number of Parking Spaces Needed:
Do You Have Any Pets?
Yes
No
If Yes, What Kind of Pet(s)?
1 Cat
2+ Cats
Dog(s)
Other
Do Any Applicants Smoke? Please note, lessees will be charged for smoke damages and cleaning.
Yes
No
Type of Apartment Preferred (select all that apply):
Efficiency
One Bedroom
One Bedroom with Garage
Two Bedroom
Two Bedroom Townhouse
Three Bedroom
Anything Else You'd Like to Share?
Submit
Should be Empty: