Future Residents

Date of Application *

MM

DD

YYYY

Desired Date of Occupancy *

MM

DD

YYYY

Roommate 1

First Name

Last Name

Roommate 2

First Name

Last Name

Roommate 3

First Name

Last Name

Applicant Legal Name *

Your name as it appears on a legal document

First Name

Last Name

Applicant Preferred Name

The name you wish to be called.

First Name

Last Name

Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Student *

Yes

No

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date Moved In *

MM

DD

YYYY

Landlord Phone *

(###)

###

####

Previous Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date Moved In

MM

DD

YYYY

Date Moved Out

MM

DD

YYYY

Landlord Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Supervisor Phone

(###)

###

####

Bank Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference Name *

First Name

Last Name

Phone *

(###)

###

####

Reference Name *

First Name

Last Name

Phone *

(###)

###

####

Have you ever been evicted? *

Yes

No

Have you ever broken a rental agreement? *

Yes

No

Have you ever been sued for non-payment of rent or damages to a rental unit? *

Yes

No

Have you ever been convicted of a felony? *

Yes

No

In case of emergency, please contact *

First Name

Last Name

Phone *

(###)

###

####

In order to verify your identity, a photocopy of a valid form of identification will need to be submitted. *

I Agree

A $40 application fee is due upon submission. How will your application fee be paid? *

Venmo

PayPal

Mail Check

A deposit of LAST MONTH’S RENT and a security deposit of ONE MONTH’S RENT is due when the lease is signed. Once the deposits are paid in full, the property will be reserved for you and your roommates. *

I Agree

Are you interested in living in this property for more than one year? *

Yes

No

Unknown

Applicant represents that all of the above statements are true and complete and hereby authorizes verification of the above information, references, and credit reports. Applicant acknowledges that false information herein may constitute grounds for rejection of this application, termination of right of occupancy, and/or forfeiture of deposits and may constitute criminal offence under the laws of this state. *

I Agree

The parties agree that this application may be electronically signed. The parties agree that the electronic signature appearing on this agreement are the same as handwritten signatures for the purpose of validity, enforceability, and admissibility. *

I Agree