Residential Leasing Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Select an agent *Marc JeretMario JosephJohn SmargiassiStreet address of the apartment you would like to rent *Apartment numberNumber of bedrooms *One bedroomTwo bedroomsThree bedroomsFour bedroomsFive bedroomsToday's date *Name of applicant *FirstLastSocial security number *Date of birth *Cell phone number *Email *EmailConfirm EmailName of spouseFirstLastSpouse's social security numberSpouse's date of birthSpouse's cell phone numberSpouse's emailName and ages of children* Remember to upload birth certificatesApplicant's current addressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMonthly rentDate moved inName of current landlordFirstLastAddress of current landlordPhone number or email of current landlord *Applicant's prior street address, city, state and zipApplicant's prior phone numberApplicant's reason for movingPerson who referred youName and phone number of your personal referenceFull address of your personal referenceApplicant's employer and job description *Length of employment Years: 0 Annual salaryEmployer's full street addressName and contact information of supervisorOther source(s) of income and annual amountSpouse's employer and job description Length of spouse's employment and annual salaryFull address of spouse's employerName and phone number of spouse's supervisor at workBank Name and full addressBank account numbersCredit cardsCredit card account numbersMake, model and year of vehicleLicense plate numberDriver's license number* Include this information of anyone living with youName and phone number of your credit referenceFull address of your credit referencePlease upload your driver's license or passport * Click or drag files to this area to upload. You can upload up to 6 files. * Include the same for anyone living with youPlease upload birth certificates Click or drag files to this area to upload. You can upload up to 10 files. Please upload any bank statements and W2's Click or drag files to this area to upload. You can upload up to 12 files. Please upload any employment letters Click or drag files to this area to upload. You can upload up to 10 files. Please upload a copy of your vouchers Click or drag files to this area to upload. You can upload up to 5 files. Terms, Please Read Carefully: I HEREBY AUTHORIZE LANDLORD TO OBTAIN INFORMATION IT DEEMS DESIRABLE IN THE PROCESSING OF MY APPLICATION, INCLUDING CREDIT REPORTS, CIVIL OR CRIMINAL ACTIONS, RENTAL HISTORY, EMPLOYMENT/SALARY DETAILS, POLICE AND MOTOR VEHICLE RECORDS, AND ANY OTHER RELEVANT INFORMATION, AND RELEASE LANDLORD, ITS EMPLOYEES AND AGENTS FROM ALL LIABILITY FOR ANY DAMAGE WHATSOEVER INCURRED IN FURNISHING OR OBTAINING SUCH INFORMATION. UPON APPROVAL AND ACCEPTANCE, THE APPLICANT AGREES TO EXECUTE A LEASE BEFORE POSSESSION IS GIVEN AND TO PAY THE SECURITY DEPOSIT AND THE FIRST MONTH’S RENT WITHIN FIVE DAYS AFTER BEING NOTIFIED OF ACCEPTANCE (TIME BEING OF THE ESSENCE); FAILING WHICH THE APPLICANT FEE SHALL BE RETAINED BY LANDLORD AS THE AGREED COMPENSATION FOR CREDIT INVESTIGATION, PROCESSING AND VERIFICATION SHALL HAVE NO FURTHER OBLIGATION TO THE APPLICANT. IN NO EVENT IS THE APPLICATION FEE REFUNDABLE TO THE APPLICANT, EXCEPT IN THE EVENT THAT LANDLORD FAILS TO DELIVER POSSESSION OF THE PREMISES AS MAY BE REQUIRED BY ANY LEASE EXECUTED BETWEEN THE PARTIES. THE APPLICANT HEREBY WAIVES ANY CLAIM FOR DAMAGES BY REASON OF NON-ACCEPTANCE OF THIS APPLICATION WHICH THE LANDLORD OR HIS AGENT MAY REJECT WITHOUT STATING REASONS FOR SO DOING. IT IS FURTHER AGREED THAT IF ANY INFORMATION HEREIN IS FALSE, THE LEASE MADE ON THE STRENGTH OF THIS APPLICATION, MAY AT THE OPTION OF THE LANDLORD, BE TERMINATED AT ANYTIME. Have you ever been evicted? *YesNoDo you have any pets? *YesNoAcknowledgment *I have read this form carefully, including the Terms like Apartment employment Digital signature *ALL PARTIES INVOLVED AGREE THAT THIS DOCUMENT MAY BE SIGNED ELECTRONICALLY. THE ELECTRONIC SIGNATURES APPEARING ON THIS DOCUMENT ARE THE SAME AS HANDWRITTEN SIGNATURES FOR THE PURPOSES OF VALIDITY, ENFORCEABILITY AND ADMISSIBILITY. Social security number *Date of signature *Caseworker InformationCaseworker's name, phone number and email, if applicablePlease upload any casework information Click or drag files to this area to upload. You can upload up to 6 files. Submit
