Ackley Properties LLC New Customer Rental Registration Form

Ackley Properties LLC New Customer Rental Registration Form
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail
example@example.com
Date you need the appliance?

MonthDayYear
Date
Rentals
prevnext( X )
Top Load Washer and Dryer
Classical top load washer, with your front load dryer. $50 per month

$50.00



Front Load Washer and dryer
The newer style front load washer, and dryer. $75 a month.

$75.00



Traditional
Refrigerator, monthly fee depends on style

$50.00



Side by side / Freezer on Left, Fridge on Right
Price depends on if there is a water line or not.

$60.00



French Door Style with Freezer on bottom.
Price depends on if there is a water line and style

$80.00



Total

$0.00
How did you hear about us?*
If requesting a refrigerator. We need the width and height of the area where the refrigerator will be. Put measurements in below. Width first and Height Last. Ex. 48w X 70h (If no Fridge put N/A)*
Any additional information we need to know? Specifically type of unit, if you only need a dryer or washer and not a full unit (1 unit is a washer and dryer. 0.5 is a just a washer or just a dryer) (all in one, be clear on what you need or want.)
BasementFirst floorSecond floorApartment/townhome
Address appliance’s will be used at?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Suggestions if any for further improvement:
YesNoMaybe
There is a $25 non refundable processing fee. A $25 delivery hook up fee and a $100 deposit for the units. The $100 deposit will be returned when units are picked up by Ackley Properties LLC, inspected and still in working conditions.
Signature: By signing you are allowing Ackley Properties LLC to contact you and send you a lease agreement. Your unit will not be assigned to you until a lease agreement is signed at the a deposit has been completed. Your signature states all above information is correct and you agree to the fees stated above!
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