CALIFORNIA APPLICATION TO LEASE

One Application must be filled out COMPLETELY by each adult applicant.

WARNING: This application may be refused and/or rejected if it is not signed, completed, or legible; if satisfactory identification is not presented; if
any information is false, cannot be verified, or does not meet Owner's criteria; if additional information is requested from Applicant and is refused;
or a Co-Applicant is rejected.

Application Type: Resident 


Print Full Name: Last, First, Middle Date of Birth Social Security # or ITIN Other names used in the last 10 years
Jocilaine de S. C. Borges 05/16/1975 W9096874 (drive)
Photo ID/Type Number Issuing Government/State Expiration Date
passaport GC217846 BRASIL 01/17/2031

Email Address Cell Phone Number Home Phone Number Work Phone Number
jucycandidoborges@gmail.com 650 389-3129 617 335-7947


RESIDENCE
Present Address (Number, Street, City, State, Zip) Rent 
X Own  Other  Current Payment
2217 E Leland Road, Pittsburg, CA, 94565 $ 2,650
$ per month
Date In Date Out Owner/Agent Name Owner/Agent Phone Number

03/04/24 Wesley Monteiro 9254309259

Previous Address (Number, Street, City, State, Zip) Rent  Own  Other 
X Previous Payment

1031 BEARDON DR, CUPERTINO 92014 $ per month

Date In Date Out Owner/Agent Name Owner/Agent Phone Number

12/13/2023 03/03.2024 Erika Cruz 650 630-1496

Full names and dates of birth of all other occupants who will reside with you:
06/03/81
Name: Lucio Antonio Leite Borges Date of Birth:
Matheus Henrique Candido Borges 02/06/08
Name: Date of Birth:

Name: Marianna Lucia Candido Borges 11/12/09 of

Date Birth:

Name: Date of Birth:

Name: Date of Birth:

Do you have a pet? YES  x

NO  How many?

PET 1: Name: Type:

Weight: Age: Breed: Color: PET 2: Name:

Type: Weight: Age:

Breed: Color:

Have you ever been evicted or asked to move? YES  x

NO  What Year?

County and State where filed:

Do you owe an outstanding balance to another apartment community or landlord? YES  x

NO  What Year?

Name of Owner/Agent:

Have you ever been convicted of a felony that involved an offense against property, persons, government officials, or that involved firearms, the selling,
distributing, or manufacturing of illegal drugs, or sex or sex crimes, in the previous seven (7) years? YES  x
NO 

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 CALIFORNIA APPLICATION TO LEASE

Applicant Name (Printed) Lucio Antonio Leite Borges

EMPLOYMENT or other verifiable source of income

Present Employer (If self-employed, name of business) Phone Number Type of Business Position Dates of Employment
Restaurant Cafe de Casa 4153451055 Chief cooking Cooking Chief 06/14/24
Business Address (Number, Street, City, State, Zip) Supervisor Name Supervisor Phone Number Monthly Gross Income
685 Beach St, San Francisco , CA, 94109 Amanda 4158663767
$ 10000 per month
Monthly Gross Additional Verifiable Income Source of Additional Verifiable Income Total Gross Monthly Income:
(Monthly Income + Additional Verifiable)

$ per month $ per month

Example: Pension, Investment Income/Dividend, Social Security, Alimony, Student Loan)

PERSONAL
In case of emergency, please notify: (Local name, address and phone number)
Name Cell Phone Number Home Phone Number Work Phone Number
Ericka Cruz 6506301496 6506301496 6506301496
Address (Number, Street, City, State, Zip) Relationship
1031 Beardon Drive, Cupertino, 92014 Friend

Reference Name: Address: Phone Number: Length of Acquaintance:

Claudia Lopez 1272 Hookston Road, Concord 9257661202
Breno Bravo Burligame 6197506368

Please list all automobiles:

Make Model Year Color License Number State of Issue Electric Plug-In

Ford Fusion Titanium 2018 white 9APA423 x

YES  NO 

chevrolet Malibu 2016 white YES  NO x



YES  NO 

YES  NO 

Do you own any recreational vehicle? YES  NO x



PARKING OF RECREATION VEHICLES, BOATS, LARGE TRUCKS OR TRAILERS IS PROHIBITED.

Do you own a waterbed? YES  NO 
x
Are you a member of the Armed Forces (including the National Guard and Reserve)? YES  x
NO 

x
Do you have renters insurance? YES  NO 

YOU WILL BE REQUIRED TO CARRY A MINIMUM $100,000 LIABILITY POLICY.

PROOF WILL BE REQUIRED UPON MOVE-IN.
How did you first learn of the apartment community?

 Drive by/Signs

 Rental Magazine Please Specify:

 Internet Please Specify:


x Referral Name, Phone # & Unit # Moises
 Apartment Locator Service Please Specify:

 Other Please Specify:

What feature(s) attracted you to this Apartment Community?

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 CALIFORNIA APPLICATION TO LEASE

Applicant Name (Printed) Lucio Antonio Leite Borges

This application is made for the purpose of procuring rental of herein described premises, and for credit clearance.

Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application and all
supporting documents whether or not it is approved. I hereby authorize SARES REGIS Management Company, through its designated agent and its
employees to check my credit, employment, and rental history, and to answer questions about my credit experience. I understand that should I lease an
apartment, SARES REGIS Management Company, and its agents shall have a continuing right to review my credit information, rental application,
payment history and occupancy history for account review purposes and for improving application methods.

I hereby agree to release and hold harmless SARES REGIS Management Company, its agents, servants and employees from any and all liability, legal
proceedings and costs including attorney's fees arising out of either the verification of the information contained on this application form or the release of
this information to other parties.

All of the above data and information set forth herein including, but not limited to, the statement of my income and financial condition is warranted to be
true and accurate and to fully and correctly state my financial condition as of the date of this application. I also covenant and agree to notify you of any
changes in the status of any of the aforementioned items during the period of my tenancy.

It is also understood that the application fee is not a deposit and will not be refunded or applied to rent if applicant is approved or denied.

PRIVACY POLICY: visit www.srgliving.com. If you have questions or comments about our Privacy Policy, or wish to make any requests with respect to your
personal information, please contact us at:

SRG Residential
Toll Free: 1-888-501-7297
Email: privacyadmin@sares-regis.com

06/24/24
Applicant's Signature Date Signed

Signature of Leasing Consultant Date Signed

For Office Use Only

Government Issued Photo ID verified? Employee Initials
YES  NO 
SS#/ITIN confirmed with applicant? Address:
YES  NO 
Total Income confirmed with applicant? Apt. Type:
YES  NO 
Page 1 Checkboxes reviewed? Move-In Date:
YES  NO 
Application signed by applicant? Rent $
YES  NO 

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