Please fill out the following form as completely as possible. We will require your signature in person or via a faxed version before actual rental terms will be discussed.
If you would prefer to fax this application, please download a printable/faxable version here.
Our office fax number is
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desired lease date |
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property location |
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applicant's name |
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phone number |
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email address |
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names of persons who would be living on the premises |
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do you have a pet? |
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type of pet |
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present address |
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city/state/zip |
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automobile make |
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year |
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license |
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state |
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length of time at present address |
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landlord name or company and phone # |
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previous landlord or company name and phone # |
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employer and phone # |
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position and length of employment |
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salary and full time/part time |
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immediate supervisor's name |
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employed from / to |
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present source of income and amt. per month |
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if you are receiving student financial aid or scolarships, please indicate source of aid and the amount |
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other sources of funds which you use to pay living expenses |
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social security# |
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driver's license # and state of issue |
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date of birth |
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credit reference #1 (name, address, phone) |
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in case of emergency contact (name, address, phone, relationship) |
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have you ever filed for bankruptcy? date filed? |
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have you ever been evicted? |
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have you ever been convicted of a felony? |
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I (we) hereby make application for occupancy of the described apartment home on the terms specified. The actual date of possession is subject to timely vacation of the premises by prior tenants, and the completion of necessary repairs or cleaning.
If this application is approved, I (we) agree to enter into an Agreement of Lease for the apartment /home, terms and rental as outlined herewith. At the time the Agreement of Lease is executed, the full Security deposit is due and payable to lessor. The Security Deposit will be held, without interest, as security for the performance of the covenants of the lease and as a damage deposit.
I (we) affirm the above information to be true and correct. All persons and/or firms named above may freely give any requested information concerning me (us) and I (we) hereby waive all right of action for any consequence resulting from such information. Further, I (we) give my (our) permission to FaciliTech Management to run a credit check on my (our) name(s) with a credit agency. |
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