Rental Application

Each adult (** years or older) may be asked to fill out a separate application.

First Name Middle Birth Date

Home Phone

Birth Date Relationship

Cell Phone

Social Security # Driver’s License #

Email address (optional)

All other proposed occupants

Last

Street Address

City, State & Zip

Last Rent Amount Paid

Owner/Manager

and Phone Number

Reason for Leaving

Is/Was Rent Paid in Full?

Were you asked to move?

Dates of Residency

Current Residence Previous Residence

From/To

Rental/Residence History

Employment History

From/To

Employer

City & State

Employer’s Phone Number

Occupation

Name of Supervisor

Salary/Hourly Rate

Dates of Employment

Current Employment Previous Employment

From/To From/To

Credit History

Savings Accounts

Checking Accounts

Credit Cards

Auto Loans

Support Payments

Other Payments

Bank/Institution Name Balance on Deposit or Balance Owed Payment Amount not applicable

not applicable

over

Chestnut Place

PROPERTIES

Vehicles Number of vehicles owned by you and any proposed occupants: Make and Model Color Year License Plate

Emergency Contacts

Name

Street Address

City, State & Zip

Phone Number

Relationship

By signing the application, you grant us permission to communicate with the contacts listed in this section in the event we can’t locate you. Furthermore, if you abandon the apartment for any reason, then you grant us permission to allow the contacts listed above to remove all contents of the dwelling on your behalf. Emergency Contact #1 Emergency Contact #2

How long do you expect to be renting from us?

Have you had any reccuring problems with your current apartment or landlord? If yes, please explain: How many pets do you have? List type, breed, age and approximate weight. Have you been party to a lawsuit in the past? If yes, please explain why: We may run a credit check and a criminal background check. Is there anything we might find that you would like to comment on ? List any verifiable sources and amounts of income you wish to have considered (optional): How did you hear about this apartment?

Have you ever been served

a late-rent notice?

Have you ever filed for bankruptcy?

If so, when?

Have you or ever been served an

eviction notice? If so, when?

Have you or any occupant ever

been convicted of a felony?

When would you be able to move in? Do you or any occupants smoke? General Information

Agreement and Authorization Signature

I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal background check to be made, verification of the information I provided, and communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for an apartment and does not consistitute a rental or lease agreement in whole or part. Signature: Date: Please email your completed application to ad3r7j@r.postjobfree.com or fax to 858-***-****

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