PLEASE PRINT                                                                                    

Applicant’s Name	Social Security Number	Date of Birth	Occupancy Date
Home Phone	Cell Phone	Work Phone	Address
Present Address	Apt. No.	City, State, Zip	Type ____________
How Long at above address	Rent              Own	Present Mo. Rent or Mortg.	Rental Rate
Previous Address	E-Mail:	Date Apt. Needed:	Approved      ______   Rejected       ______
Name of Employer
Occupation
Address		Phone	Lease From          To
How Long		Annual Income
Name of Co-Resident	Address	City, State, Zip	Co-Resident D.O.B
Co-Resident Social Security	E-Mail:	Phone:
Co-Resident Employer	Address	City, State, Zip	Annual Income
Vehicles
Make	Year/Color	Model	License #
Make	Year/Color	Model	License #
References Name	Address		Phone
Name	Address		Phone
Name	Address		Phone
Pets Name                                                                  Weight                                 Type	List all other Applicants
Name                                                                  Weight                                 Type

 PO Box 6006

Watertown, NY  13601

 

In the event I choose not to enter into the lease, I shall waive all rights to and shall forfeit said deposit as payment for resultant liquidation damages. 

 

The Landlord shall, within 5 days after receipt of this application, notify me if this application is not approved and accepted, and return the deposit with the exception of $35.00 which will be retained for the cost of the criminal check and credit report.

The undersigned makes the foregoing representations knowing that if any of such proves false, owner at his option may cancel any lease given in reliance upon such information.

 

Address of  Apartment: __________________________________________________________________.

 

 

I promise to execute a lease for one year (12 months) at a monthly rate of $_________________________.

 

The undersigned hereby grant Landlord permission to obtain any additional information deemed appropriate pertaining to my personal and financial records.

 

Signature _________________________________________________________________      Date__________________

 

Signature ________________________________________________________________        Date __________________