Rental Application
Application Fee: $50.00 A one-time, non-refundable application fee of $50 is required to submit this application.
Property to Occupy
*
Desired Date of Occupancy
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Total Number of Adults to Occupy the Apartment (age 18 and older)
*
Total Number of Children to Occupy the Apartment (under the age of 18)
*
*No pets allowed.
Primary Applicant's Information
Name
*
First Name
Middle Name
Last Name
Social Security Number
*
Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Drivers License Number
*
Driver's License State of Issue
*
i.e., Illinois
Cell Phone Number
*
Format: (000) 000-0000.
Email Address
*
example@gmail.com
Emergency Contact: First Name, Last Name, Cell Phone Number
*
Primary Applicant's Rental and Criminal History
Has the Primary Applicant ever...
Been evicted or asked to move out?
Declared bankruptcy within the past 4 years?
Been sued for non payment of rent?
Been arrested for a felony or misdemeanor involving: violent or sexual crime, fraud, embezzlement, theft, public lewdness, indecent exposure, destruction of property, violence, stalking, fire arm crimes, illegal drugs, or any other crime involving a minor that was resolved by conviction, probation, or deferred adjudication?
Other
If No, please type "None" in the box below. If Yes, please explain each item below...
*
Primary Applicant's Vehicle Information
What is the Make, Model, and Color of the Primary Applicant's Vehicle?
*
(i.e., Ford, F-150, White)
Primary Applicant's Current Residence
Address
*
Address
Street Address Line 2
City
State
Postal / Zip Code
Zip Code
*
How Long At This Address?
*
Monthly Rent/Mortgage Payment $
*
Landlord Name/Mortgage Company
*
Landlord Phone Number
*
Format: (000) 000-0000.
Have you given written notice to your current landlord of your intent to leave?
Yes
No
Primary Applicant's Employment History
Employed By
*
Supervisor's Name
*
Supervisor's Phone Number
*
Format: (000) 000-0000.
Length of Employment
*
Department or Position
*
After-Tax Monthly Income
*
Employer's Address
*
Address
Street Address Line 2
City
State
Postal / Zip Code
Other Income (source and amount)
Co-Applicant's Information (if applicable)
Name
First Name
Middle Name
Last Name
Social Security Number
Date of Birth
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Driver's License Number
Driver's License State of Issue
i.e., Illinois
Cell Phone
Format: (000) 000-0000.
Email Address
example@example.com
Co-Applicant's Rental and Criminal History
Has the Co-Applicant ever...
Been evicted or asked to move out?
Declared bankruptcy within the past 4 years?
Been sued for non payment of rent?
Been arrested for a felony or misdemeanor involving: violent or sexual crime, fraud, embezzlement, theft, public lewdness, indecent exposure, destruction of property, violence, stalking, fire arm crimes, illegal drugs, or any other crime involving a minor that was resolved by conviction, probation, or deferred adjudication?
Other
If No, please type "None" in the box below. If Yes, please explain each item below...
Co-Applicant's Vehicle Information
What is the Make, Model, and Color of the Co-Applicant's Vehicle?
(i.e., Ford, F-150, White)
Co-Applicant's Employment History (if applicable)
Employed by
Supervisor's Name
Supervisor's Phone Number
Format: (000) 000-0000.
Length of Employment
Department or Position
After-Tax Monthly Income
Co-Applicant's Employer's Address
Address
Street Address Line 2
City
State
Postal / Zip Code
Zip Code
Other Income (source and amount)
Signature(s) and Terms & Conditions
By signing, both the Primary Applicant and Co Applicant (if applicable), hereby confirm that each has read, understood, and agrees to the Rental Agreement Terms & Conditions as detailed in the below hyperlink.
Primary Applicant's Full Legal Name
*
Today's Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Co Applicant's Full Legal Name (if applicable)
Today's Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Payment Amount
*
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USD
$50
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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