Jefferson House Apartments Rental Application

Jefferson House Apartments - Rental Application
Applicant Type (Select One):
Applicant Type
Full Legal Name:
Date of Birth:

MonthDayYear
Date
Last 4 of SSN:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Current Address:
Rent:
Landlord/Company:
Phone:
Format: (000) 000-0000.
Dates:
Previous Address:
Rent:
Landlord/Company:
Phone:
Format: (000) 000-0000.
Dates:
Employer Name:
Position:
Monthly Income:
Emergency Contact 1: Name:
Address:
Phone:
Format: (000) 000-0000.
Emergency Contact 2: Name:
Address:
Phone:
Format: (000) 000-0000.
Personal Reference 1: Name:
Address:
Phone:
Format: (000) 000-0000.
Personal Reference 2: Name:
Address:
Phone:
Format: (000) 000-0000.
References may be used as emergency contacts if needed.
Occupancy Example:
A 2-bedroom occupied by 4 adults = $50 per additional adult = $100 additional monthly rent.
Deposit Requirement: Deposit is due within 24 hours after approval unless other arrangements are
made.
Community Policies Acknowledgment:

No pets are allowed on the property.

No Smoking is permitted inside the building.

Screening Authorization:
Applicant authorizes verification of all information, including credit, criminal, rental, and employment
history.
IMPORTANT NOTICE:
All applicants age 18 or older must submit a separate application. One must be Primary ($50), others
Add-On ($10 each).

Applications will not be processed until all required documents and fees are received. Application fees are non-refundable.

Applicant certifies that all information provided is true and complete. Any false, misleading, or omitted information may result in denial of the application.

If misrepresentation is discovered after approval or occupancy, it will be considered a breach of the rental agreement and may result in termination of tenancy and/or legal action.

PLEASE BE ADVISED THAT TENANTS ARE REQUIRED TO START ELECTRIC AND GAS SERVICE IN YOUR NAME PRIOR TO THE COMMENCEMENT OF THE LEASE.

INDEPENDENCE UTILITIES 816-325-7880

SPIRE GAS 1-800-582-1234
Photo I.D.

Cancelof
Income Verification

Cancelof
Desired Move In Date:

MonthDayYear
Date
Signature:

USD

Jefferson House Apartments - Rental Application