RENTAL APPLICATION to be completed by each ADULT APPLICANT

Verified Driver's License or State I.D. FULL REPORT CREDIT PLUS FAST FACTS
□ Yes □ No □ □ □
□Co-Signer □ W/ Current Tenant Application Received:_____________________

MANAGEMENT COMPANY COMMUNITY NAME CONTACT

MOVE-IN DATE UNIT # MONTHLY RENT $ LEASE TYPE DESIRED TELEPHONE

( )
APPLICANT INFORMATION
LAST NAME FIRST MIDDLE DOB SOCIAL SECURITY # DRIVER'S LIC. #

ROOMMATE(S) NAME(S) EMAIL

CURRENT RESIDENCE
STREET ADDRESS APT # CITY STATE ZIP

HAVE YOU GIVEN LEGAL NOTICE TO VACATE? MOVE-IN DATE: MONTHLY RENT $
RENT□ TELEPHONE
YES □ NO □ OWN □
MOVE-OUT DATE: ( )
LANDLORD/MTG. COMPANY CITY STATE ZIP LANDLORD DAY PHONE LANDLORD EVENING PHONE
( ) ( )
REASON FOR VACATING: LIST ALL ROOMMATES:

PREVIOUS RESIDENCE
STREET ADDRESS APT # CITY STATE ZIP

DID YOU GIVE LEGAL NOTICE TO VACATE? MOVE-IN DATE: MONTHLY RENT $
RENT□ TELEPHONE
YES □ NO □ OWN □
MOVE-OUT DATE: ( )
LANDLORD/MTG. COMPANY CITY STATE ZIP LANDLORD DAY PHONE LANDLORD EVENING PHONE
( ) ( )
REASON FOR VACATING: LIST ALL ROOMMATES:

EMPLOYMENT / INCOME
CURRENT EMPLOYER POSITION TELEPHONE SUPERVISOR'S NAME SALARY/MON DATE OF HIRE
( ) TH

PREVIOUS EMPLOYER POSITION TELEPHONE SUPERVISOR'S NAME SALARY / FROM: TO:

( ) MONTH

ADDITIONAL SOURCES OF MONTHLY INCOME (List all income to be included for qualification): SOURCE: TELEPHONE

$ / Month
( )
BANK NAME BRANCH TELEPHONE CHECKING ACCT # SAVINGS ACCT #
( )
EMERGENCY CONTACT
NAME RELATIONSHIP ADDRESS TELEPHONE
( )
ADDITIONAL INFORMATION
LIST ALL VEHICLES TO BE PARKED ON SITE OTHER OCCUPANTS
MAKE MODEL YEAR COLOR LICENSE# STATE OCCUPANT NAME D.O.B.

TYPE AND SIZE OF PETS:

HAVE YOU ESTABLISHED RETAIL CREDIT? YES □ NO □
WILL YOU BE MOVING IN ANY OF THE FOLLOWING ITEMS?
DO YOU HAVE RENTERS INSURANCE? YES □ NO □
WATERBED □ AQUARIUM □ MUSICAL INSTRUMENT □ Carrier:_____________________ Policy #:________________________
IF YES, PROVIDE DATE(S) AND LOCATION(S):
HAVE YOU EVER BEEN EVICTED? YES □ NO □
HAVE YOU OR ANY PERSON WHO WILL OCCUPY THE UNIT EVER BEEN CONVICTED, PLEAD GUILTY, NO-CONTEST OR HAVE CURRENT PENDING
CHARGES TO ANY FELONY OF MISDEMEANOR?
YES □ NO □ DESCRIBE OFFENSE: DATE OF OFFENSE:

ARE YOU OR ANY PERSON WHO WILL OCCUPY THE UNIT A REGISTERED SEX OFFENDER?

YES □ NO □ IF YES, DATE AND LOCATION OF REGISTRATION:

THE FOLLOWING INFORMATION IS SUBJECT TO CHANGE PRIOR TO EXECUTION OF THE RENTAL AGREEMENT

RENT DEPOSITS FEES

THE FOLLOWING ARE MAXIMUM AMOUNTS. THE ACTUAL

AMOUNT CHARGED WILL DEPEND ON UNIT SIZE, SECURITY DEPOSIT MINIMUM $_________________ LATE RENT PAYMENT FEE $___________
SCREENING RESULTS, AND OTHER FACTOS.
SECURITY DEPOSIT MAXIMUM$_________________ LEASE BREAK FEE $___________
UNIT RENT $_____________________ (DEPENDS ON SCREENING RESULTS AND UNIT SIZE) (NOT TO EXCEED 1.5 X RENT)

______________________ $_____________________ PET $_________________ N.F.S. CHECK FEE OF $25 + BANK CHARGES

______________________ $_____________________ GARAGE / STORAGE $_________________ UNAUTHORIZED PET FEE $__________

______________________ $_____________________ OTHER___________________ $_________________ SMOKE ALARM / CARBON

MONOXIDE ALARM TAMPERING FEE $__________
______________________ $_____________________ OTHER___________________ $_________________
LOST KEY, ACCESS CARD FEE $__________
______________________ $_____________________ OTHER___________________ $_________________
NON-COMPLIANCE FEE* $__________
1. LATE PAYMENT OF UTILITY
2. FAILURE TO CLEAN PET WASTE
3. FAILURE TO CLEAN GARBAGE/RUBBISH
APPLICANT'S INITIALS__________________ APPLICANT SCREENING CHARGE $______________ 4. PARKING VIOLATIONS OR IMPROPER USE OF VEHICLES
* NOT TO EXCEED $50 PER NON-COMPLIANCE

GOOD FAITH ESTIMATE

Approximate number of units currently available, or which will in the forseable future be available, of the size and in the area requested by applicant: _______ unit(s).
Approximate number of applications previously accepted and currently under consideration for those units: _________ application(s).
If the blanks above are not filled in, then there is at least one unit available and there are no applications ahead of yours currently under consideration.

I certify that the above information is correct and complete and hereby authorize you to do a credit check and make any inquiries you feel necessary to evaluate my
tenancy and credit standing. I understand that giving incomplete or false information is grounds for rejection of this application. If any information supplied on this
application is later found to be false, this is grounds for termination of tenancy. Owner/Agent has charged a screening charge as set forth above. Applicant screening
entails the checking of the applicant’s credit, rental history, employment history, public records and other criteria for residency. The applicant has the right to dispute
the accuracy of any information provided to the owner/agent by the screening service or credit reporting agency. Applicant’s copy of this signed application shall be
the receipt for the screening charge. The screening service is Pacific Screening Inc., P.O. Box 25582, Portland, OR 97298 (503) 297-1941. If the applicant is approved,
applicants will have _________ hours from the time of notification to either execute a rental agreement and make all deposits required thereunder or make a deposit
to execute a rental agreement which will provide for the forfeiture of the deposit if applicants fail to execute the rental agreement. If applicants fail to timely take the
steps required above, they will be deemed to have refused the unit and the next application for the unit will be processed. Owner / Agent shall have no liability to
applicant until such time as a rental agreement is signed by both parties. Applicant acknowledges receipt of a copy of the Criteria for Residency. The information
contained in this application is true and complete.

Signed ________________________________________________ (Applicant) Dated ______________________

Signed ________________________________________________ (Agent for Owner) Dated ______________________