Apartment Online Application

Applicant

When would you like to move in?*


Please select a time-frame.

How long do you expect to reside in the unit?*


Please selecta time-frame.

First Name*


Enter your first name.

Middle Name*


Enter your middle name or NMN.

Last Name*


Enter your last name.		    

Include any prior names or aliases.

First Name

Middle Name

Last Name

    

Birth Month*


Select month.

Birth Date*


Select date.

Birth Year*


Select year. 		     

Home/Cell Phone*


Enter your home phone.Enter a valid phone number.Minimum number of characters not met.

Work Phone*


Enter your work phone.Invalid format.Minimum number of characters not met.

Other Phone

    

Social Security Number*


Enter your Social Security Number.

Driver’s License Number*


Enter your license number.

Email Address*


Enter your email address.Enter a valid email address.		    

Other Identifying Information

        

Attach a copy of your driver’s license or social security card.

This is not required but can expedite the application and move-in process.

Vehicle Information

Do you own a vehicle?*

Please make a selection.

Make

Model

Color

Year

License Plate Number

State

      

Additional Occupants

Please note that all additional occupants listed here, that are 18 years old or older, need to fill out a separate, complete application.

First Name

LastName

Relationship

Age

  

First Name

LastName

Relationship

Age

  

First Name

LastName

Relationship

Age

  

Rental History

Current Address*


Enter current address.		        

City*


Enter address.

State*


Select state.

Zip Code*


Enter zip code.		    

From*


Select month.

 


Select year.

To*


Select month.

 


Select year.		      

Rent*

$
Enter monthly rent.

Security Deposit*

$
Enter security deposit.		      

Landlord/Manager*


Enter landlord/manager name.

Landlord/Manager Phone*


Enter phone number.		      

Reason for Leaving

      
         

Previous Address

        

City

State

Zip Code

    

From

 

To

 

      

Rent

$

Security Deposit

$ 		     

Landlord/Manager

Landlord/Manager Phone

      

Reason for Leaving

      

Employment History

Self-employed applicants: Attach tax returns for the past two years.

Current or Most Recent Employer

Company Name*


Enter employer name.		        

Address*


Enter address.		        

City*


Enter city.

State*


Please select State.

Zip Code*


Enter zip code.		    

Phone*


Enter phone number.		        

Supervisor*


Enter supervisor name.

Phone*


Enter phone number.		      

Position/Title*


Enter your last position.		        

From*


Select month.

 


Select year.

To*

Select month.

 


Select year.		      

Previous Employer

Company Name

        

Address

        

City

State

Zip Code

    

Phone

        

Supervisor

Phone

      

Position/Title

        

From

 

To

 

      

Income

Include all forms of income (food stamps, child support, any government assistance, etc.).
Enter 0(zero) if any of the income sources do not apply to you.

Your gross monthly employment income (before deductions):

 $ Enter employment income.*

Average monthly amounts of other income (specify sources):

  

Social Security

 $ Enter social security income or 0.*

Food Stamps

 $ Enter food stamp income or 0.*

Child Support

 $ Enter child support income or 0.*

Unemployment

 $ Enter unemployment income or 0.*

Other Income Source

 $ Enter other income or 0.*

Bank Accounts

Bank/Institution*


Enter bank or financial institution.

Checking

Savings

Average Account Balance

$

Bank/Institution

Checking

Savings

Average Account Balance

$

Other Monthly Financial Obligations

Car Payment

Name of Creditor

Amount Owed

$

Monthly Payment

$

Student Loan

Name of Creditor

Amount Owed

$

Monthly Payment

$

Collection Agency

Name of Creditor

Amount Owed

$

Monthly Payment

$

Credit Card or Other Obligation

Please Specify

Name of Creditor

Amount Owed

$

Monthly Payment

$

Personal Information

Do you smoke?*

Please make a selection.

Have you ever filed for bankruptcy?*

Please make a selection.

If you answered YES:

How Many Times?

When did you file?

    

What types of bankruptcy?

    

Have you ever been sued?*

Please make a selection.

If you answered YES:

How Many Times?

When was the lawsuit filed?

    

Concerning what?

    

Have you ever sued anyone else?*

Please make a selection.

If you answered YES:

How Many Times?

When was the lawsuit filed?

    

Concerning what?

    

Have you ever been evicted?*

Please make a selection.

If you answered YES:

How Many Times?

When were you evicted?

    

City

State

    

Have you ever been convicted of any crimes?*

Please make a selection.

If you answered YES:

For what offense(s)?

When were you convicted?

    

What was the sentence?

State

    

Are you required to register as a sexual offender pursuant to any state’s law?*

Please make a selection.

If you answered YES:

For what offense(s)?

When were you convicted?

    

 

Where are you registered?

    

Use this area to further explain any "Yes" answers.

Do you have pets? *

Please make a selection.

Do you have any water-filled furniture, including fish tanks.*

Please make a selection.

If yes, describe the water-filled furniture you wish to have in the rental property?

      

References and Emergency Contact

Personal Reference 1

First Name*


Enter first name.

Last Name*


Enter last name.

Relationship*


Enter relationship.		    

Address*


Enter address.		        

City*


Enter city.

State*


Select state.

Zip Code*


Enter zip code.		    

Phone*


Enter phone number.		        

Personal Reference 2

First Name*


Enter first name.

Last Name*


Enter last name.

Relationship*


Enter relationship.		    

Address*


Enter address.		        

City*


Enter city.

State*


Enter state.

Zip Code*


Enter zip code.		    

Phone*


Enter phone.		        

Source

Where did you hear about this vacancy?

Certification

I certify that all the information given above is true and correct and understand that my lease or rental agreement may be terminated if I have made any materially false or incomplete statements in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers, and personal references. I give permission for the landlord or its agent to obtain a consumer report about me for the purpose of this application, to ensure that I continue to meet the terms of the tenancy, for the collection and recovery of any financial obligations relating to my tenancy, or for any other permissible purpose. I understand that typing my name in the signature box below and submitting this form is the electronic equivalent of my ordinary signature and is legally binding carrying the same weight as my handwritten signature.

                             

Digital Signature

Digital Signature text goes here.*


Enter your signature.

Month*


Select month.

Today’s Date*


Select today’s date.

Year*


Select year.