*

DESIRED DATE OF OCCUPANCY *

DESIRED DATE OF DEPARTURE  *

DO YOU HAVE PETS?  Yes What kind?

DO YOU OR ANYONE THAT WILL LIVE WITH YOU SMOKE?

PERSONAL INFORMATION
(an asterisk indicates a required field)

APPLICANT

FULL NAME *

DATE OF BIRTH  *

SOCIAL SECURITY *

PHONE NUMBER

EMAIL ADDRESS *

CO-APPLICANT

FULL NAME

DATE OF BIRTH 

SOCIAL SECURITY

PHONE NUMBER

EMAIL ADDRESS

NAMES AND AGES OF OTHER RESIDENTS IN YOUR PARTY:

APPLICANT EMPLOYMENT HISTORY

EMPLOYERS NAME *

EMPLOYERS ADDRESS *

SUPERVISOR TELEPHONE

POSITION HELD * HOW LONG? YEARS MONTHS

HOUSEHOLD GROSS MONTHLY INCOME

CO-APPLICANT EMPLOYMENT HISTORY

EMPLOYERS NAME

EMPLOYERS ADDRESS

SUPERVISOR TELEPHONE

POSITION HELD HOW LONG? YEARS MONTHS

HOUSEHOLD GROSS MONTHLY INCOME

 

APPLICANT RESIDENCE HISTORY

PRESENT STREET ADDRESS

CITY STATE ZIP

LENGTH OF TIME AT ADDRESS YEARS MONTHS

DO YOU OWN THE PROPERTY YES NO

LANDLORD'S NAME TELEPHONE #

MONTHLY RENT

REASON FOR MOVING

APPLICANT REFERENCES

PERSONAL REFERENCE (NON-FAMILY)

TELEPHONE

ADDRESS

RELATIONSHIP

OTHER INFORMATION

APPLICANTS DRIVERS LICENSE #

CO-APPLICANTS DRIVERS LICENSE #

TOTAL NUMBER OF AUTOMOBILES

MAKE YEAR COLOR

PLATE# STATE

MAKE YEAR COLOR

PLATE# STATE

 

HAVE YOU EVER FILED FOR BANKRUPTCY? YES

HAVE YOU EVER BEEN EVICTED FROM ANY TENANCY OR HAD AN EVICTION NOTICE SERVED ON YOU? YES *

HAVE YOU EVER WILLFULLY REFUSED TO PAY RENT DUE? YES *

HAVE YOU EVER BEEN ARRESTED OR CONVICTED OF A CRIME? YES *
IF YES PLEASE EXPLAIN:

 

MILITARY PERSONNEL ONLY

MY COMMANDING OFFICER IS: TITLE AND TELEPHONE

MY RANK AND UNIT ARE:

 

AUTHORIZATION

I/WE HEREBY MAKE APPLICATION FOR AN APARTMENT AND HEREBY AUTHORIZE CHRIS KELLEY OR ANY AGENT OF CHRIS KELLEY TO CONTACT ANY PRIOR EMPLOYERS, LANDLORDS, COMPANIES, CREDIT BUREAUS, AND/OR LAW ENFORCEMENT AGENCIES FOR THE PURPOSE OF VERIFYING, RECORDING, AND/OR CONFIRMING THE ABOVE INFORMATION WHICH I HEREIN STATE IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

APPLICANT'S FULL NAME *

SOCIAL SECURITY # *

CO-APPLICANT'S FULL NAME

SOCIAL SECURITY #

BY ENTERING YOUR FULL NAME (INCLUDING MIDDLE NAME IF APPLICABLE) AND YOUR SOCIAL SECURITY NUMBER
IN THE FIELDS ABOVE, YOU AGREE TO ALL TERMS AND CONDITIONS, WRITTEN OR IMPLIED.

Apex Rentals :: Chris Kelley :: 207.899.5001