APPICATION FORM FOR TENANT.

REFUN DABLE FEE : $100

Applica nt Name :
Date of Birth:
Current Address:
Apt #:
City:
Email Address:
Mobile Phone:
State:
PERVIOUS ADDRESS:
ZIP:
Home phone:
Street Address:
City:
Mont hly Rent:
Resided o n premises from:
To:
State:
Date in:
Date out:
Reason for moving :

WHEN DO YOU PLAN TO MO VE IN.

Date out:
I hereby Ap ply to rent /Lease Apartment Number
At
Per month upon approval of my application and si gned rental agreement, for a refundable secu rity depos it
in the amount of $400
Under this rental agreement the tenant agrees to rent the above -mentioned residence on a month -to-month
basis with a monthly rental amount of
To pay rent o f $
Hereby state and represent that the information in this app lication is complete and accurate . I under stand
that in t he event o lease is entered into it maybe cancelled by the landlord if any of th e information
provided in t he applicat ion is m aterially in accurate or in compl ete, I hereby authori ze the landlord of
landlord’s agent s to verify the formation on the application .
Application Signature :
Landlord Signature: