Applicant*
Home Tel*
Work Tel
Cell
Date of Birth*
Social Security # *
Driver's License # *
State*
Email Address*
Co-Applicant/Spouse
Home Tel
Date of Birth
Social Security #
Driver's License #
State
Email Address
Have you or your co-applicant/spouse ever been convicted by a court of law?* YesNo
If yes, please explain
Have you or your co-applicant/spouse ever been convicted of any felony offense?*YesNo
Full Name
Age
DOB
Relationship
In case of emergency, notify (other than occupants)*
Tel*
Mailing address of emergency contact
Do you have any pets? If so, please specify breeds and weights*
Street Address, City, State, Zip*
Landlord/Mortage Co.*
How Long?*
Rent Payment?*
Street Address, City, State, Zip
Landlord/Mortage Co.
Tel
How Long?
Rent Payment?
Company Name*
Job Title*
Supervisor*
Length of Employment*
Monthly Income*
Company Name
Job Title
Supervisor
Length of Employment
Monthly Income
Source
Amount per month
Make/Model/color
License Plate #
County/State
Applicant(s) understand and agree that this application shall not be considered by management until the application fee of $100 is paid. Applicant(s) understand and agree that the application fee is used by management for the payment of processing this application, which includes costs for verifying the authenticity of the information provided and to obtain or otherwise procure information regarding applicant's credit history, criminal background, and rental reference. As such, applicant(s) understand and agree that the application fee is nonrefundable. Applicant(s), by signing this application for occupancy, represent that the information provided herein is true and correct to the best of their knowledge. In the event that management discovers that any information herein is false, resident understands and agrees that management may, at management's sole option, reject this application and immediately rescind any current or future agreement with applicant(s).
List and describe: $200 Administration Fee
By signing this application for occupancy, the undersigned applicant(s) authorize management to obtain a consumer credit report and any other information necessary in management's sole discretion to assist in the evaluation of this application for occupancy. Applicant(s) understand and agree that any such information obtained by management may include, but is not limited to applicant's credit history, salary information and history, vehicle records, driver license records, driving history, or any other information. Applicant(s) release management its principals. investors, employees, agents, vendors, the owner(s) of the community or property generally described in this application, and any furnisher or supplier of information related to this application from any and all liability in the procurement use, distribution and possession of all obtained information. Applicant(s) also understand and agree that all information provided in this application and the other consumer reports, to include credit reports, criminal records, evidence of any civil litigation, and civil judgements, records of arrest, past rental history, employment history, salary information/history, vehicle records, driver's license records, driving history, or any other information may be provided to state, local, and/or federal government agencies. Any disposal of information received by management shall be done in accordance with 16 CFR part 682 and N.C. Gen Stat. 75-64, et seq.
Signature*
Date*
Co-Applicant's/Spouse's Signature
Date
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