Select one * Select one* Montego Place Shoreham Park Housing
Type of Accommodation Desired Type of Accommodation Desired Apartment Townhouse Housing
Bedrooms Bedrooms 1 2 3 4+
Date Needed
Full Name *
Status * Status* Single Married Widowed Divorced
Age *
Co-tenant
Status * Status* Single Married Widowed Divorced
Age *
Social Security No. of Applicant *
Social Security No. of Spouse or Co-Tenant
Present Address
Phone *
City *
State *
Zip *
Address Past 3 Years
Reason for Leaving
Total Number of Persons to Occupy Suite * Total Number of Persons to Occupy Suite * 1 2 3 4 5 6 7 8 9 10
Adults * Adults* 1 2 3 4 5 6 7 8 9 10
Children Children 1 2 3 4 5 6 7 8 9 10
Age(s) of Children (separate with comma)
NOTICE: ONE CHILD PER ROOM — MAXIMUM 2 ADULTS TO OCCUPY A ONE BEDROOM APARTMENT. (NO INCREASE IN OCCUPANTS IS ALLOWED WITHOUT WRITTEN PERMISSION OF LESSOR OR AGENT.)
Current and Past Residence
Name & Address of present landlord *
Former Landlord (if present address is less than 3 yrs.)
Amount of rent *
How many years at this address *
Landlord’s phone no. *
Have you ever been evicted for nonpayment of rent? * Have you ever been evicted for nonpayment of rent?* Yes No
Or other reasons? Or other reasons? Yes No
If yes, explain:
Tenant’s Employer
Job Title
Address
Who to contact *
Phone *
Length of Service
Monthly Income
Other Income
Source of Other Income
Checking Account With *
Branch *
Savings Account With *
Branch *
Type of Automobile *
Year *
License Plate No. *
State of Registry *
Balance Due on Automobile
Monthly Payment
To Whom
Number of Autos you will keep at this address
NOTICE: ONLY ONE AUTOMOBILE ALLOWED PER ADULT TENANT — Boats, Trucks, Trailers, Motorcycles, Inoperable or Unlicensed Automobiles, Campers & Recreational Vehicles are Prohibited on the Premises.
Name
Address
Relationship
Phone
Name
Address
Relationship
Phone
Name of Company
Address
Phone
Please list two emergency contacts
Name *
Relationship *
Phone *
Street Address
City
State
Zip
Name *
Relationship *
Phone *
Street Address
City
State
Zip
Have you ever been convicted of a felony? Have you ever been convicted of a felony? Yes No
Have you ever been convicted of a misdemeanor? Have you ever been convicted of a misdemeanor? Yes No
If yes, explain:
The undersigned warrants and represents that all statements herein are true and complete and hereby authorizes lessor or agent to check references, verify income, employment, rental history and obtain a written credit report. Application subject to landlord accepting credit rating. If lessee wants a signed lease canceled, it is understood that the deposit will be forfeited.
All applicants MUST acknowledge these terms by entering their initials and checking the box below.
I accept these Terms & Conditions. *
Signature / Initials *
Date Signed *
Signature / Initials (Co-tenant) *
Date Signed *
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