Name
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First Name
Last Name
Email Address
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Social Security Number
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Phone
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(###)
###
####
Date of Birth
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MM
DD
YYYY
Current Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Apartment Type
One Bedroom
Two Bedroom
Desired Location
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Employer
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Job Title
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Have you ever filed for Bankruptcy?
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Yes
No
Have you ever been evicted?
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Yes
No
I HAVE READ, AGREE AND AFFIRM THAT ALL OF MY STATEMENTS AND INFORMATION PROVIDED IN THIS APPLICATION ARE TRUE AND COMPLETE. I ACKNOWLEDGE THAT FALSE, UNDISCLOSED, INCOMPLETE OR MISLEADING INFORMATION HEREIN MAY CONSTITUTE GROUNDS FOR REJECTION OF THIS APPLICATION, TERMINATION OF RIGHT OF OCCUPANCY OF ALL RESIDENTS AND OCCUPANTS UNDER A LEASE AND/OR FORFEITURE OF DEPOSITS AND FEES, AND MAY CONSTITUTE A CRIMINAL OFFENSE UNDER THE LAWS OF THIS STATE. I UNDERSTAND THAT THIS APPLICATION IS PRELIMINARY ONLY AND DOES NOT BIND YOU TO EXECUTE A LEASE OR TO DELIVER POSSESSION OF THE PREMISES TO ME. I AUTHORIZE YOU TO CONTACT ANY REFERENCES LISTED ABOVE AND TO OBTAIN CONSUMER REPORTS, WHICH MAY INCLUDE CREDIT, RENTAL PAYMENT AND/OR EVICTION HISTORY AND CRIMINAL BACKGROUND INFORMATION ABOUT ME AND IN ORDER TO VERIFY THE ABOVE INFORMATION. I UNDERSTAND THAT AS MY PROSPECTIVE LANDLORD, ANY CO-APPLICANTS, OCCUPANTS, OR GUARANTORS THAT MAY BE ADDED TO THIS APPLICATION MAY NEED TO CONNECT TO AND SUCCESSFULLY PASS CONSUMER BACKGROUND SCREENING REPORTS. BY AGREEING, I AUTHORIZE YOU TO OBTAIN SUBSEQUENT CONSUMER REPORTS, INCLUDING CREDIT REPORTS, TO ENSURE THAT I CONTINUE TO SATISFY THE TERMS OF MY TENANCY, FOR THE COLLECTION AND RECOVERY OF ANY FINANCIAL OBLIGATIONS RELATING TO MY TENANCY, OR FOR ANY OTHER PERMISSIBLE PURPOSE. FURTHER, IF I HAVE INCLUDED INFORMATION ON CO-APPLICATIONS, OTHER ADULT HOUSEHOLD MEMBERS, AND/OR GUARANTORS ON THIS APPLICATION, I AFFIRM THAT THOSE INDIVIDUALS HAVE KNOWLEDGE OF THEIR INCLUSION ON THIS APPLICATION AND EXPRESSLY AUTHORIZE YOU TO OBTAIN SUBSEQUENT CONSUMER REPORTS, INCLUDING CREDIT REPORTS. I UNDERSTAND THAT YOU MAY REPORT ALL POSITIVE AND NEGATIVE RENTAL PAYMENT HISTORY TO CONSUMER REPORTING AGENCIES WHO TRACK THIS INFORMATION FOR LANDLORDS, MORTGAGE COMPANIES AND OTHER CREDITORS. I AND ALL OCCUPANTS OR GUARANTORS HEREBY RELEASE FROM ALL LIABILITY OR RESPONSIBILITY ALL PERSONS AND CORPORATIONS REQUESTING OR SUPPLYING SUCH INFORMATION.
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I Agree
No Thanks
I agree and certify that all the above is true
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