"*" indicates required fields Applicant Name* Address City State Zip Cell Phone Email How Long at Current Address Current Landlord/Agent Social Security Landlord/Agent Phone Monthly Payments Driver License Number Date of Birth Month Day Year How many late payments in 12 months Please give Previous Residential HistoryPrevious Address (if less than 2 years)Address City State Zip How long at Previous Address Previous Landlord/Agent's Phone Previous Monthly Payments How many previously late payments Reason for moving Employment Status: Full_time Student Selfemployed Part_time Retired Unemployed Position Salary ($) Supervisor's Name Supervisor's Phone How Long? Type of Bank Account: Checking Savings Bank Name Checking Bank Name Savings Personal Reference/Emergency Personal Reference Phone Have you ever filed for Bankruptcy? Yes No Have you ever been evicted from Tenancy? Yes No Have you ever been Convicted of a Felony? Yes No By your input of your electronic signatures you hereby agree that the electronic signatures that you apply on this document are representations of your signature and are legally valid and binding as if you had signed the document with ink on paper in accordance with Uniform Electronic Transactions Act (UETA) and the Electronic Signatures in Global and National Commerce Act (E-SIGN) of 2000. This document complies with requirements and the standards of the Electronic Signatures in Global and National Commerce Act 9E-SIGN ACT) effective October 1, 2000, the Uniform Electronic Transaction ACT (UETA), and the Government Paperwork Elimination ACT (GPEA). I have read and agree to the above terms and conditionsSignatureI/We recognize that as a part of your procedure for processing my application an investigative consumer report may be prepared whereby confidential information is obtained. The information above is considered to be true and correct to the best of my/our knowledge. I/We agree and permit you or your agent to investigate my/our credit, tenant history, banking, employment, etc. for the purpose of renting. The cost is $95.00 per person and is not refundable. I/We agree to execute a signed lease within 3 days of credit approval notice and pay the balance of the security deposit. The keys and possession are given when all money due has been collected in full and prior to the move in date. First month’s rent is not due and payable until the lease start date. Please upload these documents Copy of Goverment Issued photo ID (ie: Driver's License, Passport, Military ID, etc.)No File Chosen Drop files here or Select files Max. file size: 1 GB. Proof of income/employment (eg. paystub, Bank Statement, Social Security, etc.)No File Chosen Drop files here or Select files Max. file size: 1 GB. Any other documents requested by the landlordNo File Chosen Drop files here or Select files Max. file size: 1 GB. Total Price:
