APARTMENT DESIRED: 1 bedroom/1 bath standard (600 square feet) $600 per month 1 bedroom/1 bath deluxe (800 square feet) $635 per month 2 bedroom/2 bath standard (1080 square feet) $725 per month 2 bedroom/2.5 bath townhouse (1280 square feet) $810 per month 3 bedroom/2 bath wing (1350 square feet) $860 per month 3 bedroom/2 bath standard (1520 square feet) $880 per month 3 bedroom/2 bath deluxe (1680 square feet) $935 per month 4 bedroom/2.5 bath standard (2200 square feet) $1300 per month 4 bedroom/2.5 bath deluxe (2400 square feet) $1350 per month 5 bedroom/4 bath (2160 square feet) $1475 per month

Name: Soc. Sec. #: D.O.B.:
Spouse: Soc. Sec. #: D.O.B.:
Current Voter:  Yes No    State  
Address City: State:  
Zip: Telephone:

Name of prior apartment community:
Person paid rent to: Telephone:
Monthly payment: Lease date from: to:
Reason for moving:
Previous address: City:
State: Zip:

Name of prior apartment community:
Person paid rent to: Telephone:
Monthly payment: Lease date from: to:
Reason for moving:
Previous address: City:
State: Zip:

ADDITIONAL OCCUPANTS:
(1) DOB:
(2) DOB:
(3) DOB:
(4) DOB:
(5) DOB:
(6) DOB:

PET(S):
How many: Kind: Type:
Weight:   Height:

Vehicle make: Yr: License #: Color:
Vehicle make: Yr: License #: Color:
Driver's License No.: State:  
Spouse's Driver's License No.: State:

EMPLOYMENT DATA:

CURRENT Employer: Address:
City: State: Zip: Phone:
From/To: Position:
Supervisor: Gross Monthly Income:
PREVIOUS Employer: Address:
City: State: Zip: Phone:
From/To: Position:
Supervisor: Gross Monthly Income:
SPOUSE Employer:  Address:
City: State: Zip: Phone:
From/To: Position:
Supervisor: Gross Monthly Income:
EMERGENCY CONTACT:
Name: Address: Phone:

FINANCIAL DATA:

Checking Account: Bank: Address:  
Acct. #: Open  Closed
Savings Account: Bank: Address:  
Acct. #: Open Closed

OTHER INCOME / ASSETS:

Etc. Account No. Monthly Income:

READ THE FOLLOWING AND THEN SUBMIT YOUR APPLICATION.

This is to inform you that as part of our procedure for processing your application, and that the applicant agrees that a Criminal Background Check will be made and that conviction or no contest pleas on any drug related charges or any felony charges will result in the applicant being denied. An Investigative Consumer Report may be prepared whereby information is obtained through personal interviews with your landlord, employer, or others with whom you are acquainted. This inquiry includes information as to your character, general reputation, personal characteristics, mode of living, and credit report. You have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation (Fair Credit Reporting Act). I/We hereby agree in the event of the approval of this application, to execute a lease in accordance with the terms set forth in this rental application and my/our rental liability shall commence on (month/date), 20 (year), pursuant to the terms of the lease. That if I/we fail to sign the lease and/or pay agreed rental, security deposit, utility fees, or other required charges as shown in this rental application, the $35.00 accompanying this application shall be forfeited to the landlord. Accompanying holding fee is non-refundable after 3 days. Owner and/or agent for the owner reserves the right to reject this application and to refuse possession of the above-mentioned accommodation. I/We have read the foregoing, certify that the information herein is TRUE and CORRECT, that this application is submitted for the purpose of inducing approval of this application in my/our behalf.

Name/Signature of Applicant: Date:
Name/Signature of Applicant: Date:

NOTE: If you prefer, you can print out your completed application, 
including the signature(s) of the applicant(s) and fax it to:
(904) 739-3381.