APPLICATION FOR RENTAL
(PAGE 2 OF 2)
Application for Rental (EPM) v1 Page 2 of 2 Revised 09/19/06
EQUAL HOUSING
OPPORTUNITY
Personal References
NAME OF NEAREST RELATIVE
RELATIONSHIP
ADDRESS
CITY
STATE
ZIP
TELEPHONE #
NAME OF PERSONAL REFERENCE
RELATIONSHIP
ADDRESS
CITY
STATE
ZIP
TELEPHONE #
Criminal Background Information
Do you or do any of your occupants have charges pending against you or against them for any criminal offense(s)? Applicant Yes No Occupants Yes No
Have you or have any of your occupants ever been convicted of, or pleaded guilty or no contest to, any criminal offense(s)
or had any criminal offense(s) disposed of other than by acquittal or a finding of “not guilty”?
Applicant Yes No Occupants Yes No
Any litigation, such as: evictions, suits, judgments, bankruptcies, foreclosures, etc.? Applicant Yes No Occupants Yes No
If “Yes” to any of the above questions, give details and dates:
How did you hear about our community? Internet (which site?)
Walk-By Rental Publication (Which One?) Rental Agency (Which One?)
Locator Service (Which One?) _ Other
PLEASE READ CAREFULLY AND SIGN BELOW
Correct Information--Applicant represents that all of the above statements are true and complete. Applicant hereby authorizes Property Staff to contact any
references listed above and to obtain consumer reports, which may include criminal background information, about Applicant and any occupants in the apartment
in order to verify the above information, references, credit and criminal records. Applicant further authorizes Property Staff to obtain subsequent consumer reports
to ensure that Applicant continues to satisfy the terms of the tenancy, for the collection and recovery of any financial obligations relating to Applicant’s tenancy, or
for any other permissible purpose. Applicant hereby releases from all liability or responsibility all persons and corporations requesting or supplying such
information. Applicant acknowledges that false, incomplete or misleading information herein may constitute grounds for rejection of this application, termination of
right of occupancy of all occupants under a lease and/or forfeiture of deposits and fees, and may constitute a criminal offense under the laws of this State. This
Application is preliminary only and does not obligate Owner or Owner’s agent to execute a Lease or to deliver possession of the dwelling unit to Applicant.
I have read and agree to the provisions as stated.
Applicant Signature
Date
Application Processing Fee
required with Application: $
Total Holding Deposit Per Apartment (if any): $
(Holding Deposit Agreement required)
OFFICE USE ONLY
Apartment Number
Apartment Size/Description
Anticipated Move-in Date
Lease Start Date
Lease End Date
Monthly Apartment Rent
Property Staff Initials _____________
click to sign
signature
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