Centerville Park Apartments, Townhomes & Health Club: Rental Application

Rental Application

Note: Co-applicant must complete a separate Rental Application Form

Applicant Information

Name:		Phone:
Date of Birth:		Social Security No.
Spouses Information
Name:		Phone:
Date of Birth:		Social Security No.
Number of persons to reside in apartment:
Name of all persons to reside in apartment:

Pet Information

Type of Pet:		Breed:
Weight:	Age:	Characteristics:
Type of Pet:		Breed:
Weight:	Age:	Characteristics:

Residential Information

Current Address (City, ST zip):
Move-in Date:
Reason for Leaving:
Landlord:
Phone:
Previous Address (City, ST zip):
Move-in Date:
Reason for Leaving:
Landlord:
Phone:

Employment Information

Your Status:
Current Employer:		Previous Employer:
Date Employed:		Date Employed:
Supervisor:		Supervisor:
Phone:		Phone:
Salary:	Per:	Salary:	Per:

Spouse's Employment
Spouses Status:
Current Employer:		Previous Employer:
Date Employed:		Date Employed:
Supervisor:		Supervisor:
Phone:		Phone:
Salary:	Per:	Salary:	Per:

Please list other income sources, you may be asked to provide proof.
Amount $:			Source:

Bank References

Name of Bank:		Address:
Type of account:		Account Number:

Driving Information

Drivers License Number:
State:		Exp. Date:
Vehicle Make:	Model:	Year:	Tag No.:
Vehicle Make:	Model:	Year:	Tag No.:

General Information

Have you or your spouse ever:
Filed Bankruptcy?	Yes No
Been evicted from tenancy?	Yes No
Willfully or intentionally refused to pay rent when due?	Yes No
Convicted of a felony?	Yes No

Please give any additional information, which might help management evaluate this application:

If management has any questions about this application, please give PHONE NUMBERS where you can be located:
Day Phone(s):
Night Phone(s):
Emergency #(s):

I hereby apply to lease the above described premises for the term and upon the conditions above set forth and agree that the rent is to be payable the 1^st day of each month in advance. As an inducement to the owner of the property and the agent to accept this application, I warrant that all statement above set forth are true. I agree to the payment of a $35.00 non-refundable application fee to offset the cost of processing my application.

Upon acceptance of this application, I agree to execute a lease for () months and further agree to pay the full Security Deposit any rent due before possession is given. If the applicant chooses not to enter into a lease agreement, the applicant must notify office within

seventy-two (72) hours after application approval. Such notice shall entitle the applicant to the return of any deposits made in connection with this application (except for the $35.00 non-refundable application fee.) The failure of applicant to timely notify the community shall result in forfeiture by applicant of the total amount of any such deposit. If this application is rejected, the applicant hereby waives any claim for damages by reason of non-acceptance which the owner or his agent may reject without starting any reason for doing so.

I authorize you to obtain an in connection with this application, including release of information by any bank, savings and loan, employer (present or former), landlords, and any lender. I understand that I can request the name of the reporting agencies providing this information. We do business in accordance with the fair Housing Act (The Civil rights Act of 1968, as amended by Fair Housing Amendments Act of 1988) which provides that it is illegal to discriminate against any person because of race, color, religion, sex, handicap, familial status (having one or more children) or national origin in the rental of housing.

The above information, to the best of my knowledge, is true and correct.

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