APPLICANT INFORMATION
Full Name:
Social Security Number:  Date of Birth (MM/DD/YYYY):
Pet Information (If Applicable):
E-mail Address:
Unit(s) Interested In:

HOUSING REFERENCES
Current Street Address:  Your Phone No.:
City:  State:  ZIP Code:
How Long have you Lived There:  Amount of Rent or Mortgage:
Landlord Name:  Landlord Phone No:

Previous Street Address:
City:  State:  ZIP Code:
How Long have you Lived There:  Amount of Rent or Mortgage:
Landlord Name:  Landlord Phone No:

EMPLOYMENT REFERENCES
Current (Local) Employer:  Phone No.:
City:  State:  ZIP Code:
How Long have you Worked There:
Supervisor:  Wage Rate:

2nd Employer:  Phone No.:
City:  State:  ZIP Code:
How Long have you Worked There:
Supervisor:  Wage Rate:

Previous Employer:  Phone No.:
City:  State:  ZIP Code:
How Long did you Work There:
Supervisor:  Wage Rate:

Total Annual Income:

FINANCIAL INSTITUTIONS/CREDIT INFO
Credit Cards (Check all that you have)
American Express   VISA   Master Card   Discover   Other (Name:)

Checking Account
Bank:  City:  State:

Savings Account
Bank:  City:  State:

EMERGENCY CONTACT INFORMATION
Full Name:
Home Phone:  Work Phone:
Street Address:
City:  State:  ZIP Code:

OTHER GENERAL INFORMATION
Check each box if the answer is yes
Have you ever been evicted or served an eviction notice?
Have you ever failed to pay rent when due?
Have you ever filed for Bankruptcy or consulted with a bankruptcy attorney?
Have you ever been arrested or convicted for other than a traffic offense?

Please Explain and YES Answers Below

Do you have the right to legally enter a lease or other contract?
Yes                     No

APPLICANT ACKNOWLEDGEMENT
Please Read the Following Statement Carefully.  If you agree to the statement, type in "I (your name) agree" in the box after the statement.  We cannot process this application unless you do this.

   Applicant acknowledges that this application process is a pre-screening tool for the Landlord for the purposes of pre-qualification.  Applicant will still be required to fill out and sign a written application for final approval.
   Applicant hereby consents to routine inquiry of references and credit agencies to provide applicable information concerning applicant's character, address, creditworthiness, reliability, and income and hereby authorizes references named here to release this information.
   This application is for pre-qualification only.  This application is NOT a rental agreement, contract, or lease!  There is NO Earnest Money being submitted with this application.  All applications are subject to the approval of the owner or managing agent.

I warrant that I am at least 18 years of age and that all statements herein are true and correct, to the best of my knowledge.

Acknowledgement:  Date (MM/DD/YYYY):