Fillable RENTAL APPLICATION cy syndrome (AIDS) or AIDS-related conditions

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RENTAL APPLICATION cy syndrome (AIDS) or AIDS-related conditions

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  • 104 other fields

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RENTAL APPLICATION
PROPERTY: ______________________________________
Instructions: Please complete ALL sections of this application. ALL adult household members must
complete a separate application. Submitting duplicate copies will be cause for rejection of all applicants.
With respect to the treatment of applicants, the Management Agent will not discriminate against any individual
or family because of race, color, creed, national or ethnic origin or ancestry, religion, sex, sexual preference,
gender identity, age, disability, handicap, military status, source of income, marital status or familial status,
acquired immune deficien
cy syndrome (AIDS) or AIDS-related conditions (ARC), or any other arbitrary basis.
General Information
1.
What size unit are you applying for: # Bedroom(s) _________________
2.
Do you require
that your apartment be designed for the disabled. __YES __NO
Please explain type of unit needed:
3. Do you own any pets? _____YES _____NO
4. How did
you hear about us? ___Online ___Friend ___Drive By ___Other
List ALL household members that are applying to live in the unit.
Name
First, Middle Initial, Last
Relationship to
Head of
Household
M/F
Social
Security
Number
Birthdate
Month,
Date, Year
Current Address:
_________________________________________________________________________________________
Street Number City State Zip
From: _____________________ To: ______________________
Daytime Phone: ______________________
Evening Phone: ______________________
Email Address:
____________________________________
YES ___ NO___
1. Do you expect any additions to the household within the next 12 months?
Name & Relationship:
Explanation:
YES ___ NO___
2. Is there anyone living with you now who won’t be living with you at this property?
Name & Relationship:
YES___ NO___
3. Are there any absent household members who under normal conditions would
live with you
?
(For example, a household member away in the military.)
Explanation:
Household Information
FOR OFFICE USE ONLY:
Date App. Recv’d: _____________
Time:_____________
Received By:___________________
1 | P a ge
Rev: August 2019
YES___ NO___ 4. Are there any Veterans living in your household? If Yes, which branch of
service: USA_____ USAF______ USMC_____ USN_____
Income is co
unted for anyone 18 or older (and legally emancipated minors)
TOTAL MONTHLY HOUSEHOLD INCOME $_____________________
CURRENT EMPLOYER: ___________________________ __________________ ______________
Company Name Phone # Contact Name
1. What is your current monthly rent? $
2. Why do you want to vacate your current residence?
3. What is the size of your current residence? # of Bedrooms
PLEASE LI
ST AN EMERGENCY CONTACT:
_____________________________ _____________
_____________________________ __________________
Name Relationship Address Phone #
YES___ NO___ 1. Have you or anyone else named on this application filed for bankruptcy?
Explanation:
_____________________________________________________________________________
YES___ NO___ 2. Have you or anyone else named on this application been convicted of a felony?
Explanation:
_____________________________________________________________________________
YES___ NO___ 3. Have you or anyone else named on this application been evicted from a rental unit of any type
Including apartment, mobile home, home or trailer?
Explanation:
_____________________________________________________________________________
List your addresses for the
past THREE years.
(If additional space is required, use the back of this page.)
Landlord’s Name/Address Your Address Own/Rent Dates
(Circle One)
Name:
Address:
Own
Rent
From:____________
To:______________
Phone: ( )
Name:
Address:
Own
Rent
From:____________
To:______________
Phone: ( )
Name:
Address:
Own
Rent
From:____________
To:______________
Phone: ( )
Rental History
2 | P a ge
Rev: August 2019
How many cars does your h
ousehold possess?
__________
List vehicle information for all vehicles:
License Plate # State Issued Make/Model/Year
Vehicle #1:
Vehicle #2:
YES ___ NO___ 1
. Will you o
r any ADULT household member require a live-in care attendant?
Name of Attendant:
Relationship (if any):
YES ___
NO___
2. Will your household be receiving a Housing Choice Voucher/Rental Assistance at
time of move-in
?
Name of Agency:
Contact Person:
PLEASE SIGN BELOW TO A
UTHORIZE THE CREDIT REPORT AND CRIMINAL BACKGROUND CHECK.
Management will perform a credit and eviction history and a criminal background check of all applicants 18 years of
age or older as a part of the applicant screening criteria. Your application will not be considered unless you provide
management with your consent to obtain a credit and criminal report on each adult household member.
______________________
_________________
Signature
I understand that management is r
elying on this information to prove my household’s eligibility for the Housing Credit
Program. I certify that all information and answers to the above questions are true and complete. I consent to
release the necessary information to determine my eligibility. I understand that providing
false information or making
false statements may be grounds for denial of my application. I also understand that such
action may result in
criminal penalties.
I authorize my consent to have management verify the information contained in this application for purposes of proving
my eligibility for occupancy. I will provide all necessary information including source names, addresses, phone
numbers, account numbers where applicable and any other information required for expediting this process. I
understand that my occupancy is contingent on meeting management’s resident selection criteria and the Housing
Credit Program requirements.
______________________________________ __________________________
Signature Date
Vehicle Information
Credit and Criminal Background Information
Rental History
3 | P a ge
Rev: August 2019
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RENTAL APPLICATION cy syndrome (AIDS) or AIDS-related conditions

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Completed 23 October 2021

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