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Application For Residency

PLEASE FILL OUT COMPLETELY
Rental Property
APPLICANT DETAILS
First Name   Date of Birth
Last Name  
Middle Name   Social Security Number
Maiden Name  
  Day Phone
   Cell Phone
Drivers Lic #   State
Have you ever had an eviction filed against you?
YES NO 		Have you ever been arrested for, convicted of or put on probation for a felony offense? YES NO
PRESENT ADDRESS
Street & Apt #   Rent Owned
City   State Zip   Dates  
Landlord Name   FROM TO
Address   Phone
 
PREVIOUS ADDRESS
Street & Apt #   Rent Owned
City   State Zip   Dates  
Landlord Name   FROM TO
Address   Phone
APPLICANTS PRESENT EMPLOYER
Name
Business Address
City   State Zip   Phone
Position   Dates of Employment
Monthly Income   FROM TO
Supervisor
 
APPLICANTS PREVIOUS EMPLOYER
Name
Business Address
City  State Zip   Phone
Position   Dates of Employment
Monthly Income   FROM TO
Supervisor
CO-APPLICANT DETAILS
First Name   Date of Birth
Last Name  
Middle Name   Social Security Number
Maiden Name  
  Day Phone
   Cell Phone
Drivers Lic #   State
Have you ever had an eviction filed against you?
YES No 		Have you ever been arrested for, convicted of or Yes No put on probation for a felony offense? YES No
CO-APPLICANTS PRESENT ADDRESS
Street & Apt #   Rent Owned
City   State Zip   Dates
Landlord Name   FROM TO
Address   Phone
 
PREVIOUS ADDRESS
Street & Apt #   Rent Owned
City   State Zip   Dates
Landlord Name   FROM TO
Address   Phone
CO-APPLICANTS PRESENT EMPLOYER
Name
Business Address
City   State Zip   Phone
Position   Dates of Employment
Monthly Income   FROM TO
Supervisor
 
CO-APPLICANTS PREVIOUS EMPLOYER
Name
Business Address
City   State Zip   Phone
Position   Dates of Employment
Monthly Income   FROM TO
Supervisor
EMERGENCY CONTACT
Name
Full Address
Contact Number
1ST AUTOMOBILE 2ND AUTOMOBILE
Year Year
Make Make
Model Model
Color Color
Tag # Tag #
CHILDREN OCCUPYING
Name   Birthday
Name   Birthday
Name   Birthday
OTHERS OR ADDITIONAL CHILDREN OCCUPYING
Name   Birthday
Name   Birthday
Name   Birthday
PETS
Keeping of pets requires Owner's Consent and a $250 nonrefundable pet fee
Breed Weight Age
Breed Weight Age
BANK REFERENCE
Name
Location
  City State Zip
   

Comments

Applicant represents that all of the statements and representations are true and complete, and hereby, authorizes verification of the above information, references and credit records. Applicant understands that an investigative consumer report including information about character, credit history, general reputation, personal characteristics, mode of living, and all public record information including criminal records may be made. Applicant agrees that false, misleading or misrepresented information may result in the application being rejected, will void a lease/rental agreement if any and/or be grounds for immediate eviction with loss of all deposits and any other penalties as provided by the lease terms if any. Applicant authorizes the Landlord and or Management Company to verify all information in this Application. Applicant has the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigation.

HOLDING DEPOSIT AGREEMENT -- Applicant has deposited a “HOLDING DEPOSIT” of $______________in consideration for the dwelling while the application is being processed. If applicant is approved by Landlord and/or Management and the lease is entered into and possession of the dwelling is taken, the “HOLDING DEPOSIT” shall be applied toward the security/damage deposit. If applicant is approved, but fails to enter into the lease within 3 days of verbal and/or written approval and/or take possession after lease signing, the FULL “HOLDING DEPOSIT” shall be forfeited to the Landlord or Management in addition to any penalties as provided in the lease if the lease has been signed by the applicant. The “HOLDING DEPOSIT” shall be refunded only if applicant is not approved. Keys will be furnished only after lease and other rental documents have been properly executed by all parties and only after applicable rentals and security deposits have been paid. This application is preliminary only, in no way implies that a particular rental unit shall be available and in no way obligates Landlord or Management to execute a lease or deliver possession of the proposed premises.

 
By Clicking on Submit, the applicant agrees to the terms, conditions and provisions stated above and in the Rental Agreement Summary.
 
 
Copyright 2008 Pacific Group International, LLC
13350 Metro Parkway, Suite 302 Fort Myers, FL 33966 USA
Tel 239-541-2300 | Fax 239-690-9834