Expected Occupancy Date:______________________________________________________

Desired length of lease: (check one) 6 mos._____ 1 year____

Garage needed, if applicable: Y or N  Other:_______________

Applicant: (name)______________________________________________________________

Home Phone #:(_____)___________________  Cell Phone #:(_____)__________________

Date of Birth:________________ Social Security Number:_________________________

Drivers license #:______________________________________ State:________________

Current Address:____________________ City:______________ State:____ Zip:_______

Current Landlord's Name and Phone Number:______________________________________

How long have you lived there? From__________ To__________ Rent Amount_________

Previous Address:___________________ City:______________ State:____ Zip:_______

Landlord's Name and Phone Number:______________________________________________

How long have you lived there? From__________ To__________ Rent Amount_________

Employed By:________________________________________ Phone:(_____)_____________

Position:___________________ If military, what Squadron:_____________ Rank:_______

Employers Address:__________________City, State, Zip Code:_____________________

Length of Employment:________years ________months   Monthly Income:____________

Other Income:__________________________________________________________________

First and Last Names and Ages of Everyone Who Will Be Living With You:_________

_______________________________________________________________________________

Do you have pets? Y or N  How many?______ If yes, describe:____________________

Pet Type/Breed:______________________ Size (Height, Weight, Age):____________________

Pet Type/Breed:______________________ Size (Height, Weight, Age):____________________

List All Vehicles: Make      Model      Year      Color      State   License#

1._____________________________________________________________________________

2._____________________________________________________________________________

Any Additional vehicles, trailers, RV's, etc: Y or N Description:

_______________________________________________________________________________

Have you ever been convicted of a crime? Y or N If Yes, explain:

_______________________________________________________________________________

Are you a registered sex offender? Y or N

Have you ever been evicted from any rental premises? Y or N If yes, explain:

_______________________________________________________________________________

Have you or are you currently engaged in drug-related criminal activity, methamphetamine use and/or involved in criminal activity that poses a threat to the health, safety or welfare of others? Y or N If yes, explain:

_______________________________________________________________________________

Personal References (unrelated to you):
Name, Address, City, State, Zip Code                      Phone

1.________________________________________________________(_____)______________

2.________________________________________________________(_____)______________

In Case of Emergency (not living with you):
(Contact: Name, Relationship, Address, City, State, Zip Code and Phone Number)

__________________________________________________________(_____)______________

I certify that the information above is true, correct and complete and is given for the purpose of obtaining credit and I authorize you and your agents to make investigations concerning any of the information. I understand that approval of this application is subject to the results of verifying the above information, including but not limited to a credit report, employment verification, and landlord reference. I understand that this application may be denied or the rental agreement may be cancelled if any information or statement in the application proves to be false. I understand that the Security Deposit will be refunded to me if the application is disapproved by Management. I understand that if I withdraw the application and/or I decide not to take the unit or I fail to execute the lease by the approved occupancy date the Security Deposit will not be refunded to me and the unit will be put back on the rental market. Landlord does not discriminate against any person on the basis of race, color, religion, sex, national origin, age, handicap, creed or familial status.

                              Applicant Signature                    Date

                              ______________________________________________