Rental Application

Date: _______________ Preferred Move-In Date: ____________

Rental Unit Applied For: _________________________________________________

Rent per month: $____________ Security Deposit: $_________________

Personal Information

Name: ____________________________________ Phone No. __________________

Social Security No.___-___-___ Driver’s License No.________________State________

Birth date: ____/_____/_____Number of people in unit: Adults:____Children:________

Current Address:________________________________________________________

City________________________________, State_____________ Zip____________

Landlord_______________________________________Phone #________________

Best time to contact:______________________How long at present address:__________

Reason for leaving: ____________________________________________________

Prior address: ________________________________________________________

City________________________________, State_____________ Zip___________

Landlord__________________________Phone #____________________________

Best time to contact:______________________How long at prior address:____________

Reason for leaving: ____________________________________________________

Employer/Source of Income:_______________________Position: _________________

How long: ________________________Monthly Income: $_____________________

Person to contact: _________________________Work phone:__ _________________

Other Occupants of Unit (All non-married adults must fill out separate applications.)

1.______________________ 2.___________________________

3.______________________ 4.___________________________

5.______________________ 6.___________________________

Not all properties allow pets, and written permission must be given by Heritage in order to have a pet. Heritage Property Management has a non-refundable, non-negotiable pet fee that may vary by property. The pet policy may change at any time at Heritage’s discretion.                              Number of pets:_______                    Type of pet:___________________

Name of Bank: ___________________________Telephone: ___________________

Address/Branch: _____________________City_____________State/Zip_________

Emergency Contact Information

Name: __________________________________Relationship: _________________

Address_____________________________________________________________

City__________________________________State/Zip______________________

Telephone No.______________________Work Telephone No._________________

Personal Reference

Name:___________________________________Relationship:_________________

Address_______________________________Telephone No.__________________

 

Other Information

Answer yes or no to the following questions:

HAVE YOU EVER:

Been arrested and/or convicted for any reason concerning illegal drugs/alcohol? _____

Been arrested and/or convicted of or pleaded guilty or "no contest" to a felony? (Whether or not resulting in a conviction)? _____

Been arrested and/or convicted of or pleaded guilty or "no contest" to a misdemeanor involving sexual misconduct (whether or not resulting in a conviction)? _____

If yes to any of the above questions, please describe: ______________________________

__________________________________________________________________________

Filed for bankruptcy?_____If yes, when?______________________________________

Been served an eviction notice or been asked to vacate a property you were renting? _____

Willfully or intentionally refused to pay rent when due? _____ If yes, please describe: _____

____________________________________________________________________

Have you given your landlord thirty days written notice? _____

How were you referred to us? Newspaper (name)________________________________

Realtor (name)_______________________Other _____________________________

Do you have a waterbed? _____

APPLICANT HAS HEREWITH (OR WILL PRIOR TO MOVE IN) DEPOSITED THE SUM OF $____________, RECEIPT OF WHICH IS HEREBY ACKNOWLEDGED AS A NON-INTEREST BEARING DEPOSIT (AND NOT AS A RENTAL PAYMENT) TO BE REFUNDED AS HEREINAFTER PROVIDED IF THE LEASE AGREEMENT IS CONSUMMATED. PROVIDED, HOWEVER, THAT IN THE EVENT THE APPLICATION IS APPROVED, AND APPLICANT FAILS OR REFUSES TO ENTER INTO THE CONTEMPLATED LEASE WITH THE OWNER, THEN APPLICANT AGREES TO FOREFEIT THE SAID DEPOSIT AS LIQUIDATED DAMAGES TO COVER THE COST OF TAKING AND OF PROCESSING THIS APPLICATION, RESERVATION AND PREPARATION OF THE APARTMENT, AND THE LOSS OF RENTAL INCOME TO OWNERS. IF, HOWEVER, IN THE EVENT THIS LEASE AGREEMENT IS NOT CONSUMMATED, IS DISAPPROVED OR FOR ANY OTHER REASON FOR WHICH OWNER IS RESPONSIBLE, THE DEPOSIT WILL BE RETURNED TO APPLICANT.

NOTE: THIS APPLICATION IS MADE WITH THE UNDERSTANDING THAT IT IS SUBJECT TO ACCEPTANCE BY THE OWNER AND SUBJECT TO EXECUTION BY SAID COMPANY AND DELIVERY OF A LEASE COVERING SAID PREMISES.

NOTE: NO OTHER PERSONS THAN THOSE LISTED ON THE PREVIOUS PAGE WILL BE AUTHORIZED TO OCCUPY THIS APARTMENT WITHOUT THE CONSENT OF THE OWNER AND AN APPROPRIATE ADJUSTMENT IN THE RENT.

NOTE: KEYS WILL NOT BE GIVEN UNTIL LEASE IS SIGNED, RENT, AND SECURITY DEPOSIT IS PAID AND APARTMENT IS READY FOR OCCUPANCY.

THE UNDERSIGNED REPRESENTS THAT ALL INFORMATION STATEMENTS ARE TRUE AND COMPLETE, AND DOES AUTHORIZE VERIFICATION OF INFORMATION AND REFERENCES GIVEN. IF ANY OF THE ANSWERS ARE FOUND TO BE DELIBERATELY INCORRECT, ANY RENTAL AGREEMENT BECOMES VOID AND WILL BE SUFFICIENT REASON FOR EVICTION AND LOSS OF SECURITY DEPOSIT. THE UNDERSIGNED ALSO AUTHORIZES VERIFICATION OF CREDIT HISTORY AND CRIMINAL RECORDS. THIS APPLICATION WILL NOT BE PROCESSED WITHOUT A SIGNATURE.

APPLICANT’S SIGNATURE__________________________________DATE______

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