|Date||Initial if over 18 year of age||Social Security No.|
|Name of Applicant||Hm Phone||Cell phone|
|Street Address||City||State||Zip Code|
|Current Landlord Name||Landlord Address, City, State||Landlord Phone No.|
|Previous Landlord Name||Address, City, & State||Phone No.|
|Name Current School Enrolled||Major||Program Length||Year of Graduation||Masters?|
|Current Employer||Co. Address, City, State||Co. Phone No.|
|Position||Business Type||Salary/Year||How Long in this Job?|
|Previous Employer||Address, City, State||Phone No.|
|How Long in this Job?|
|Reference||Address, City, State||Phone No.|
|Name of Family or Kin for emergency||How are they related to you?|
|Address, City, State, Country||Phone No.|
|Credit Card Name|
|Name of Bank where accounts are held|
|Are you a convicted felon? Yes / No||Signature|
|FOR OFFICE USE ONLY|
|Apartment No.||No. occupants? Adults Children||Base Monthly Rent|
|Address, City, State||Pets?||Ages of minor children||First Month|
|Months of Lease?||Start Lease||Lease expires||Security Deposit|
|Pursuant to State and Federal Law, the management shall not make an inquiry concerning race, religion, color, national origin, sex, sexual orientation, age (except if a minor), ancestry, or marital status of the applicant or veteran status, military service, or handicapped.
The applicant authorizes the management and renting agency to obtain a consumer credit report. The applicant warrants and represents that all statements herein are true and accurate and agrees to execute a standard form apartment lease or tenancy at will agreement, a copy of which the applicant has had an opportunity to examine, which the Lessor may choose to terminate if statements made herein are untrue.
Deposits will be applied as shown above, or applied as damages sustained by the owner except if the application is not accepted by the owner.
The renting agent is an independent contractor and has no authority to make any representations concerning the premises; The renting agent is only authorized to show the apartment for rent and assist in screening applicants. Rolls Realty Inc. provides equal housing opportunity.