Furniture is not provided, for illustration purpose only.

Applications for Apartment

 
All Fields Required. Please enter "none" or "NA" if question does not apply.
 
Applicant
Name (Last, First, Middle):
 Social Security No:
 Date of Birth:
Email:
 Emergency Contact:
 Phone Number:
Student:
YES/NO
  		College Attending:
 School or Department:
 
Co-Applicant
Name (Last, First, Middle):
 Social Security No:
 Date of Birth:

 
 
Current Residence
Address (Apt, Street, City, State & Zip):
 Phone No:
How long there?
 OWN/RENT
  		Present Landlord
 Landlord Phone No:
Amt. Present Rent?
$		 Lease Exp. Date

 		  
 
Apartment Desired		  
When Desired:
  Apartment Selection:
Bradford Manor
Long Pond Shores
Winton Village
Chili Heights
Whitney Ridge
Fetzner Square
Stone Hedge
 
Total Occupants
Total No. of persons who will live in unit:
List below all occupants not mentioned above.
(1) Occupant Name:
 Relationship:
 Date of Birth:
(2) Occupant Name:
 Relationship:
 Date of Birth:
(3) Occupant Name:
 Relationship:
 Date of Birth:

 
 
Work Infomation
  Applicant Co-Applicant
Employer's Name
Employer's Address
How long Employed
Position
Supervisor's Name
Work Telephone
Annual Income $ $
 
 
Bank Information
(1) Bank Name:
 Branch:
 Type of Account:
(2) Bank Name:
 Branch:
 Type of Account:

 
 
Vehicle Information
(1) Year:
 Make:
 Model:
 Color:
 Liscense No:
(2) Year:
 Make:
 Model:
 Color:
 Liscense No:

 
 
How did you learn about this property?
D&C Community News
Tri County Suburban News
Renter's Guide Web Site
PhoneBook SUNY Brockport Stylus
On-Line Directory Referral
Drive-By Other
 
If a student, or your major source of income is parent or guardian, please supply the following information
Parent/Guardian Name:
 Will parent/guardian guarantee rent payment? YES/NO
 
Address (Street, City, State & Zip):
 Home Phone No:
Parent/Guardian Employer:
 Work Phone No:

 
  In order to proceed, you must agree to the following DISCLOSURE:  

I (we) hereby certify that I am )we are) the person(s) making this application and that all information contained herein is true and correct in every particular. I (we) understand that while processing this application, and investigative report may be made whereby information may be obtained as to character, general reputation, personal characteristics, and mode of living (I have a right to make a written request for a complete and accurate disclosure to the nature and scope of any such investigative report).

I (we) hereby consent to allow landlord, itself or through its designated agents or employees, to obtain a consumer repot and criminal record information on me (us) and to obtain and verify my (our) credit and employment information for the purpose of determining whether to lease an apartment of house to me (us). I (we) also agree and understand that landlord and its agents or employees may obtain additional consumer reports and criminal record reports on me (us) in the future to update or review my (our) account. Upon my (our) request, you will inform me (us) whether consumer reports and criminal record reports were requested and the names and addresses of any consumer reporting agency that provided such reports.

By selecting this check box, I have read and agreed to these disclosures
   

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