Online Apartment Application Application Date * MM DD YYYY Address Applied For * Monthly Rent $ Lease Term Lease Start Date MM DD YYYY Contact Information Name * First Name Last Name Email * Phone * (###) ### #### SSN XXX-XX-XXXX Date of Birth * MM DD YYYY Drivers License * Please Include State & Number Current Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Lease Start Date MM DD YYYY Lease End Date MM DD YYYY Monthly Rent $ Landlord Name Landlord Phone Number (###) ### #### Reason for leaving Previous Address Address 1 Address 1 Address 2 City State/Province Zip/Postal Code Country Lease Start Date MM DD YYYY Lease End Date MM DD YYYY Monthly Rent $ Landlord Name Landlord Phone Number (###) ### #### Reason for Leaving Employment Information Employer Occupation Start Date MM DD YYYY Supervisor Name & Title Supervisor Phone Number (###) ### #### Annual Salary $ Other Income $ Source of other income References Business References Address of Business Reference Address 1 Address 2 City State/Province Zip/Postal Code Country Phone of Business Reference (###) ### #### Personal References Address of Personal Reference Address 1 Address 2 City State/Province Zip/Postal Code Country Phone of Personal Reference (###) ### #### Banking Reference Address for Banking Reference Address 1 Address 2 City State/Province Zip/Postal Code Country Phone for Banking Reference (###) ### #### Emergency Contacts Relationship of Contact 1 Address of Contact 1 Address 1 Address 2 City State/Province Zip/Postal Code Country Phone of Contact 1 (###) ### #### Relationship of Contact 2 Address of Contact 2 Address 1 Address 2 City State/Province Zip/Postal Code Country Phone of Contact 2 (###) ### #### Vehicle Information Year Make Model Color Plate Number Pets Type of Animal Breed Sex Color Size Small (Under 20 LBS) Medium (Between 20 - 40 LBS) Large (Between 40 and 60 LBS) X-Large (Over 60 LBS) Other Occupants Over 18 Other Occupants List Names and Birthday of all additional occupants 18 years and older Under 18 Other Occupants List Names and Birthday of all additional occupants 18 years or younger Confirmation Checkbox * I warrant that all statements contained in this application are true and accurate and that | have not knowingly withheld any information which would, if disclosed, affect my application unfavorably. I hereby provide the owner or its authorized agent with my consent to communicate with my current and former landlords, as well as my current employer(s) for the purpose of, among other things, verifying the information listed herein. | am aware that a credit history, eviction search, and criminal background check may be conducted in conjunction with my application. Any person or firm is authorized to release information pertaining to my credit history or suitability as a tenant upon presentation of this form or a photocopy of this form. It is understood that any processing fee associated with this application is non-refundable, but that any security deposit received from me will be refunded if my application is not approved. Yes Typed Signature Today's Date MM DD YYYY Thank you!
