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SOCIAL SECURITY fRESIDENTS

APPLIC'TION TO RENTTJO

M.I.

DATECALLED TOTIME INDATE BACK.TIME BACK

(JR.. SR.)

DRIVERS LICENSE

RELATIONSHIP OVER 18(or emancipated minor)Yes/No

PHOtJE NUMBERYes/No

ARE YO U OVER 18SOCIAL SECURITY*

Yes/No

STATE ZIP

COMPLEX NAME

MANAGER'S Q DATE BACK~77fS TIME BACK ]^ ''

. - - _ . lTfRST " ~ ~ " . M . I . ' (JR.. SR.) PHONE NUMBERYes/NoSOCIAL SECURITY r DRIVERS LICENSE * ARE YOU OVER 1

RESIDENTS RELATIONSHIP OVER 18 SOCIAL SECURITY #(or emancipated minor)Yes/NoYes/No

COUPLEX NAME

MANAGER'S *

* APT CrTY STATE ZIP

EVER BEEN DELINQUENT INPAYMENT OF RENT?EVER BEEN EVICTED FROMANY PROPERTY?YOULEAVING PRESENT RESIDENCE?GIVEN NOTICEYET?YES NO

MANAGER'S*

COMPLEX NAMEPLEASE EXPLAINPLEASE EXPLAIN

HOW LONG

RENT! PAID

ii (XixiflJ i Jh Rns (_ )

YOUR POSITION GROSS SALARY WKMOYR

WKMOYRYOUR POSITION GROSS SALARY

WKMOYRNAME YOUR POSITION GROSS SALARYRECEIVING CHILD SUPPORT? HOW MUCH? $RECBVING A PENSION? HOW MUCH? $ COMPANY$PROVIDE PROOF OF THESE INCOMES?

Phone Number Called.Position Length of Residency_NSFs? How many Lates? Thirty Day Notice Given? Rent/Mortgage per Month? $_Date: Employees InitialsResidence Phone Number CalledParty Position Length of ResidencyNSFs? Howmany Lates? Thirty Day Notice Given? Rent/Mortgage per Month? $_Date: Employees Initials

er Phone Number Called Length of EmploymentPosition of person that Verified Salary ? $ WK MO YRYes No* Tax Return (s)? Yes No* NewEmployment 'Offer Letter" required? *Initials Date:Employer Phone Number Called Length of EmploymentParty Position of person that Verified Salary ? $ WK MO YRYes No* Tax Return (s)? Yes No* New Employment "Offer Letter* required?Initials Date: fCopies must be attachedand must beequal to or greater than rental amount)Income Source Phone Number Called Length of employmentParty Proof of Additional Income Attached? (bank statement showing direct deposit, court order of child support.iund, copy of Sodal Security, Disability or Pension Statement, notarized letter of parental support.Tax returns or Investment

Employee's Initials Date Comments ______ _

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References

ACCT. BANK ADDRESS/BRANCH"

REFERENCES ADDRESS

PHONE * BRANCH # ACCT.* r r- *

TYPE ACCT. ACCT. #

IT REFERENCES ADDRESS TYPE ACCT. ACCT. #

ReferencesM fc

ADDRESS PHONES . RELATII

ADDRESS PHONE* RELATIONSHIP

Em ergency

'kDDRESS

Cr l*\ 7"7 7 -7.PHONES ~" ' ; f 1 "

# MAKE MODEL YEAR

* MAKE MODEL YEAR

Vehicles:

NOTE: EVERY ITEM MUST BE FILLED IN ANDCOMPLETED IN ITS ENTIRETY.REVIEW YOUR APPLICATION BEFORE YOU TURN IT IN TO THE MANAGER.

THATTHE ABOVE STATEMENTS. ARE TRUE AND CORRECT AND HEREBY AUTHORIZESTION OF INFORMATION CONCERNING SAID APPLICANT. IT IS UNDERSTOOD THE FEE OF $ IS

DEPOSITAND WILL NOT RFEEFUMTBn IF APP1IPMJT IS DECLINED.

2.DATE * '

DATE