Author: Wilma
Last saved by: HP Authorized Customer
Company: Town and Campus

RENTAL APPLICATION

 Name _______________________________  Soc. Sec. # ___________________  Date of Birth _____________
 Name _______________________________  Soc. Sec. # ___________________  Date of Birth _____________

 Name, SS# and DOB of all occupants applying   ___________________________________________________
___________________________________________________________________________________________
RESIDENTIAL OR RENTAL HISTORY

 Present  Address /Name of Community	   City 	 	State     		Zip 		   Phone

_____________________________________________________________________________________________________________

 Owner / Manager 			            Phone 	                       Monthly Payment             Length of Residency

______________________________   ________________              _____________             _________________

 Previous Address        			City 			State 		Zip 		   Phone

_____________________________________________________________________________________________________________

 Owner / Manager 			             Phone 		  Monthly Payment	     Length of Residency

______________________________      _________________         _______________          ________________

 Have you ever been evicted from any type of housing or broken a lease?  _____   if yes, Explain   _____________
____________________________________________________________________________________________________________
EMPLOYMENT AND ANNUAL INCOME OF APPLICANT

 Present  Employer                   			Address 					Position

________________________________________________________________________________________________________________
 
Salary: ___________ Length of Employment: _________ Supervisor: _______________  Phone # ______________

 Previous Employer                           		Address 					Position	     

_______________________________________________________________________________________________________________

 Salary: ___________ Length of Employment: _________ Supervisor: _______________  Phone # ______________

 Co-Applicant’s Employer                           	 Address				Supervisor 
________________________________________________________________________________________________________
 Position _______________________  Years / Months Employed  ___________  Phone # _______________

Annual Income of Applicant (Check One):
  ____  $5,000--$7,499       ____  $10,000--$12,499	       ____   $15,000--$17,499	        ___    $20,000--$30,000
  ____  $7,500--$9,999        ____  $12,500--$14,999	       ____   $17,500--$19,999	        ___    Over  $30,000

Annual Income of Co-Applicant (Check One):
  ____  $5,000--$7,499        ____  $10,000--$12,499	       ____   $15,000--$17,499	          ___    $20,000--$30,000
  ____  $7,500--$9,999        ____  $12,500--$14,999	       ____   $17,500--$19,999	          ___    Over  $30,000

BANK INFORMATION

Bank Name: ____________________________   Address: ____________________  Phone # ____________
Checking Acct. #:_____________________________            Savings Acct. # _________________________

PERSONAL REFERENCES

Name ___________________________    Address ______________________________  Phone:____________

Name ___________________________    Address ______________________________  Phone:____________

In case of Emergency, Notify:___________________________  Relationship ___________    Phone _________

Student Applications:  Name of School Attending:  _________________________________________________
Name of Parents     _____________________________________________          Phone  ___________________
Address   ___________________________________________________________________________________
                             Street				   City			State			Zip

Please list any auto you would be keeping at this address:

Make  ________________________     Color  ___________    Year  ___________     License #  _____________

Make  ________________________   Color  ___________      Year  ___________     License #  _____________

Do you have a pet?  _______      if yes, indicate kind and weight:  ____________________________________

INSURANCE: Owner and Agent carry no insurance on the personal property of tenants. It is recommended that
you obtain insurance coverage.

CERTIFICATION:   For the purpose of allowing Owner or Owner’s Agent to evaluate my application and determine 
my suitability as a resident, I hereby certify  that neither I  nor any potential occupants of  my apartment have ever been 
charged with or convicted of a felony or any crime involving theft, violence, fraud, illegal drugs, or a sexual offense of 
any kind whatsoever.

Applicant Signature ____________________________/_________________________       Date    _______________

VERIFICATION:  I represent that all of the information in this Rental Application is true and accurate to the best of
my knowledge, and   I acknowledge that The  Town  &  Campus  Apts will rely on this information in considering this application.  Furthermore, in the event that  Town  & Campus  Apts determines that any of the foregoing information is false, I waive any rights that I may have under applicable law to notice or the establishment of grounds for eviction and grant The Town & Campus Apts the unconditional right to cancel my lease and immediately cause my eviction with out prior notice or the establishment of grounds for eviction.  The applicant authorizes a credit check and verification of rental information, employment and the references given.  It is understood that the deposit and fees listed below will be returned if the applicant is rejected.  If the applicant is accepted and fails to move in, it is understood that the deposit will not be refunded.  False or incomplete information shall be cause for refection of this application. 

Applicant Signature __________________________/_________________________         Date   ________________

Manager :     ____________________________________                                                                 Date:  ________________ 

FOR OFFICE USE ONLY
Manager ________________________                                       Apt. #  ________         Rental Amount     $ _________
Approved  ________            Not Approved  ______                   Score:  ________         Guarantee Form       _________
Acceptance / Denial Notification Date Sent  ______                  Deposit Amount $_______        Date Paid      ________
Move In Date __________   Lease Date  _________                  Pet Fee Required $______         Date Paid     Comments:____________________________________________________________________________________________ 

REFERENCE WAIVER

By my signature below, I authorize a credit check and grant permission to check any 
or all employment, income and or all personal references, and any or all rental history
which I have furnished on my application.

__________________________________________            	_______________
Signature                                                                                 	 Date

__________________________________________            	_______________
Signature                                                                                 	 Date