ResADE Group Holdings HPDC PROGRAM RESIDENTIAL RENTAL APPLICATION

ResADE Group Holdings, LLC HPDC PROGRAM RESIDENTIAL RENTAL APPLICATION
TODAY'S DATE*

MonthDayYear
Date
HOW DID YOU HEAR OF US?*
FULL NAME OF REFERRAL SOURCE
Name*

First NameLast Name
Social Security Number*
Upload Government Issued Driver's License/I.D. Card*

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Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
DO YOU SMOKE?*

YesNo
Co-Applicant Name - (N/A if no co-applicant)*

First NameLast Name
Social Security Number - (All zeros if no co-applicant)*
Co-Applicant Upload Government Issued I.D. Card *

If no Co-Applicant, simply upload your Government Issued Driver's Licens/I.D. again to bypass this field.
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Relationship to Applicant*
Co-Applicant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
(CO-APPLICANT) - DO YOU SMOKE?*

YesNo
DESIRED DATE OF OCCUPANCY*

MonthDayYear
Date
DESIRED LENGTH OF OCCUPANCY*
CHOOSE ONE
NUMBER OF BEDROOMS*
NUMBER OF BATHROOMS*
NUMBER OF OCCUPANTS*
2 PERSONS PER BEDROOM
REASON FOR MOVING and WHY YOU WANT TO BE ACCEPTED INTO THE HPDC PROGRAM*
DO YOU HAVE A SECTION 8 VOUCHER*

YesNo
IF YES, PLEASE PROVIDE THE HOUSING AUTHORITY YOU ARE WITH AND THE EXPIRATION DATE OF YOUR RTA*
IF NOT APPLICABLE - TYPE N/A
MAX RENT AMOUNT YOU ARE ABLE TO PAY OR MAX AMOUNT OF VOUCHER IF SECTION 8*
SECURITY DEPOSIT SHALL BE EQUAL TO THE RENT AMOUNT.
WHERE WOULD YOU LIKE TO MOVE?*
EMPLOYMENT*

Employed Full-TimeEmployed Part-TimeSelf-EmployedUnemployed
CURRENT EMPLOYER*
IF NOT EMPLOYED - TYPE N/A
IF EMPLOYED, ENTER LENGTH OF EMPLOYMENT BELOW*

Not Employed3-5 years1-3 years5 years or more
MONTHLY INCOME:*
MOST RECENT PAY WAGE STATEMENT NO. 1*

If no Pay Wage Statements, simply upload your Government Issued Driver's Licens/I.D. again to bypass this field.
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MOST RECENT PAY WAGE STATEMENT NO. 2*

If no Pay Wage Statements, simply upload your Government Issued Driver's Licens/I.D. again to bypass this field.
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VEHILCE YEAR, MAKE, AND MODEL.*
IF MULTIPLE VEHICLES, PROVIDE EACH ONE LABELED BY A NUMBER. I.E. "1 - 2012 Honda Accord"
DO YOU OWN A PET?*

YesNo
IF PET OWNER, WHAT IS THE AGE, BREED, AND WEIGHT OF PET(S).
ACKNOWLEDGEMENT OF PET FEE: $250 PER YEAR*

Clear
ACKNOWLEDGEMENT OF ADMINISTRATIVE/MOVE-IN FEES: *$500 1ST YEAR *$250 EVERY YEAR THEREAFTER.*

Clear
PRESENT ADDRESS: *

STREET ADDRESS, CITY, STATE, AND ZIP CODE

HOW LONG AT PRESENT ADDRESS

LANDLORD'S NAMELANDLORD'S PHONE NUMBER

CURRENT RENT PAYMENT
PRIOR ADDRESS: *

STREET ADDRESS, CITY, STATE, AND ZIP CODE

HOW LONG AT PRIOR ADDRESS

LANDLORD'S NAMELANDLORD'S PHONE NUMBER

PRIOR RENT PAYMENT
I represent that the information provided in this Application is true and correct to the best of my knowledge. ResADE Group Holdings, LLC is authorized to verify the references and employment information provided in this Application and to request a credit check.

I further authorize ResADE Group Holdings, LLC to deduct the $80 application fee from the credit card provided below.

$50.00 RESIDENTIAL RENTAL APPLICATION FEE + $30 CREDIT AND BACKGROUND CHECK PAYMENT*

USDResADE Group Holdings, LLC

Credit Card Number

Signature*

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TODAY'S DATE*

MonthDayYear
Date
Should be Empty:

ResADE Group Holdings, LLC HPDC PROGRAM RESIDENTIAL RENTAL APPLICATION

Credit Card Number