application
print and Fill Out the Application then Bring it with you when you come and we'll waive the $20.00 appplication fee!!!!
This is a Tax Credit Property. Income Restrictions Apply. Call For Details
APPLICATION
PERSONAL INFORMATION: Full Name of Applicant:________________________Home Phone:_______________________Cell Phone:_________________ Birthdate:_______________________ Age:________ Disabled Y / N Social Security #_____________________________ Drivers License #_________________________State Issued_________________Marital Status (check one) __Single __Married __Widowed __Separated __Divorced __(Number of Yeras) Race (check one) __White __Black __Oriental/Pacific Islander __American Indian / Alaskan Native __Other: Is your Ethnic Background Hispanic? (check one) __Yes ___No Full Name of Co-Applicant:____________________Home Phone:_______________________Cell Phone:_________________ Birthdate:_______________________ Age:________ Disabled Y / N Social Security #_____________________________ Drivers License #_________________________State Issued_________________Marital Status (check one) __Single __Married __Widowed __Separated __Divorced __(Number of Years) LIST ALL OTHERS WHO WILL BE OCCUPYING THE APARTMENT Name:_________________________ Date of Brith:_______________Age____Social Security #____________________ Disability: ___Y ___N Relationship to Applicant:_________________________________________________________ Name:_______________________________ Date of Birth:__________________Age_______Social Security #_______________________ Disability: ___Y ___N Relationship to Applicant:________________________________________________________________________
HOUSING INFORMATION (If Additional Space is Needed, please attach a separate page. MUST HAVE 3 YEARS CONTINUOUS HISTORY Applicant's Present Address (Check One) ___Apartment ___Leased HOme ___Own Home ___Other:_______________________________________ Present Street Addresss:________________________________________Apt #:__________City:______________________State:_____Zip:____________ Present Landlord/Mortgage Co:____________________________________________________________Monthly Rent/Mortgage $__________________ Address of Landlord/Mortgage Company:_______________________________________________________Phone:________________________________ Is Landlord a Relative ___Yes ___No Relationship:______________________________Is you lease/mortgage in any other name? ___Yes ___No If Yes Please Explain and provide name:_________________________________________________________________________________________________ What is your reason for moving?________________________________________________________________________________________________________ Applicant's Previous Address (Check One) ___Apartment ___Leased Home ___Own Home ___Other:_______________________________________ Present Street Addresss:________________________________________Apt #:__________City:______________________State:_____Zip:____________ Present Landlord/Mortgage Co:____________________________________________________________Monthly Rent/Mortgage $__________________ Address of Landlord/Mortgage Company:_______________________________________________________Phone:________________________________ Is Landlord a Relative ___Yes ___No Relationship:______________________________Is you lease/mortgage in any other name? ___Yes ___No If Yes Please Explain and provide name:_________________________________________________________________________________________________ What is your reason for moving?________________________________________________________________________________________________________ Co-Applicant's Present Address (Check One) ___Apartment ___Leased Home ___Own Home ___Other:_______________________________________ Present Street Addresss:________________________________________Apt #:__________City:______________________State:_____Zip:____________ Present Landlord/Mortgage Co:____________________________________________________________Monthly Rent/Mortgage $__________________ Address of Landlord/Mortgage Company:_______________________________________________________Phone:________________________________ Is Landlord a Relative ___Yes ___No Relationship:______________________________Is you lease/mortgage in any other name? ___Yes ___No If Yes Please Explain and provide name:_________________________________________________________________________________________________ What is your reason for moving?________________________________________________________________________________________________________ Co-Applicant's Previous Address (Check One) ___Apartment ___Leased Home ___Own Home ___Other:_______________________________________ Present Street Addresss:________________________________________Apt #:__________City:______________________State:_____Zip:____________ Present Landlord/Mortgage Co:____________________________________________________________Monthly Rent/Mortgage $__________________ Address of Landlord/Mortgage Company:_______________________________________________________Phone:________________________________ Is Landlord a Relative ___Yes ___No Relationship:______________________________Is you lease/mortgage in any other name? ___Yes ___No If Yes Please Explain and provide name:_________________________________________________________________________________________________
APARTMENT REQUIREMENTS AND OTHER MATERIAL INFORMATION What is your number of bedrooms required: ________ Date Apartment Needed:_____________________Where Did You Hear About Us?______________ Will you be receiving Section 8 rental assistace? If "yes" list Agency Name, contact person and phone________________________________________ ______________________________________________________________________________________________________________________ Is there anyone living with you now who won't be living with you at this property? ___Yes ___No Who? Explain:________________________________ Do you expect any additions to your household within the next twelve months? ___Yes ___No Who? Explain__________________________________ Are there any absent household members who under normal conditions would live with you: __Yes __No Who? Explain:__________________________ Does any adult of this household have primary physical custody of every childlisted on this application? __Yes __No Not Applicable ___ If Yes Explain:___________________________________________________________________________________________________________ Does your household have or anticipate having any pets other than those used as service animals? ___Yes ___No Describe:____________________ Have you or anyone else named on this application filed for bankruptcy? ___Yes ___No Explain (provide dates)________________________________ Have you or anyone else named on this application been convicted of a felony? ___Yes ___No Explain:_______________________________________ Have you or anyone else named on this application been convicted of dealing or manufacturing illegal drugs? ___Yes ___No Explain:________________ _______________________________________________________________________________________________________________________________ Have you or anyone else named on this applicaiton broken a rental agreement or lease contract? ___Yes ___No Explain:_________________________ Have you or anyone else named on this applicaiton had legal action taken against you for nonpayment of a bill? ___Yes No___ Explain:___________________________________________________________________________________________________________________________ Have you or anyone else named on this appliction broken a rental agreement or lease contract? ___Yes ___No Explain:__________________________ Have you or anyone else named on this application been sued for property damage? ___Yes ___NO Explain__________________________________ Have you or anyone else named on this application been evicted or asked to move from a rental unit of any type including an apartment home, mobile home, or trailer? ___Yes ___No Explain:____________________________________________________________________________________________
MISCELLANEOUS INFORMATION How Many automobiles would you keep at this property? _____________________ Make:_________________ Model:___________________Year:________Color______________License#___________________State:________ Make:_________________ Model:___________________Year:________Color______________License#___________________State:________ In case of emergency, notify: _____________________________________ Relationship:____________________________ Work#:_____________________________ Home #:_________________________________Cell#_____________________________ Address:____________________________________________________________________________________________________________ (In the event of serious illness or death of resident, the above person ___may OR ___may not enter, remove and/or store all contents found in the dwelling, common areas, or mailbox.
APPLICATION FEE/SECURITY DEPOSIT, DAMAGES & SIGNATURE CLAUSE Applicant has submitted the sum of $____________________ which is a non-refundable payment for a credit and processing charge, receipt or which is acknowledged by Management. Such sum is not a rental payment. In the event this application is disapproved by Management, this sum will be retained by Management to cover the cost of processing the application as furnished by the applicant. In the event this application is approved yet applicant cancels after 72 hours of approval, there is a administrative fee for holding the unit equal to the deposit requirement. This application along with the applicant questionnaire completed by each adult in the household must be completed in total and signed before Management will process it.
I/We certify that answers given herein are true and complete to the best of my/our knowledge. I/We authorize verification or investigation of all statements contained in this application via consumer credit reports, rental history reports, criminal history reports and other means. Such authorization does not require the owner or its agents to make verifications or investigations. Failure to answer any of the above inquiries shall entitle owner to reject this application. False information given above shall entitle owner to (1) reject this applicaiton, (2) retain the applicaiton fee(s) and depoist(s) as liquidated damages for owner's time and expenses of processing this application, and (3) terminate resident's right of occupancy. Owner reserves the right to regularly and routinely furnish information to consumer reporting agencies about performance or lease obligations by residents. Such information may be reported at any time and may include both favorable and unfavorable information regarding a resident's compliance with the lease, rules and financial obligations. Owner and/or Property Manage have no duty to provide emergency care or give notice of emergency to any person and shall not be liable to applicant, Resident, any occupant, or any guest for failure to do so.
THIS APPLICATION IS NOT A RENTAL AGREEMENT, CONTRACT OR LEASE. ALL APPLICATIONS ARE SUBJECT TO THE APPROVAL OF THE OWNER OR MANAGEING AGENT.
_______________________________________________________________________________ _________________________________ Signature of Applicant Date
_______________________________________________________________________________ _________________________________ Signature of Applicant Date
_______________________________________________________________________________ _________________________________ Signature of Lessor's Representative Date
"Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fradulent statements to any department of the United States Government." HUD and any owner (or any employee of HUD or the owner) may be subject to penalties for unauthorized disclosures or improper use of information collected based on the consent form. Use of the information collected based on this verification form is restricted to the purpose cited above. Any person who knowingly or willingly requests, obtains, or discloses any information under false pretenses concerning an applicant or participant may be subject to a misdemeanor and fined not more than $5,000.00. Any applicant or participant affected by negligent disclosure of information may bring civil action for damges, and seek other relief, as may be appropriate, against the officer or employee of HUD or the owner responsible for the unauthorized disclosure or improper use. Penalty provisions for misusing the social security number are contained in the **Social Security Act at U.S. C. 208(a)(6)(7) and (8). Violations of these provisions are cited as violations of 42 U.S.C. 408(a)(6),(7) and (8).**
We encourage and support the nation's affirmative housing program in which there are no barriers to obtaining housing because of race, color, religion, sex, national origin, handicap or familial status.
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