Winn Residential |
Rental Application |
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(Co-Applicant must file separate application) Please Print |
PERSONAL: Date _______ Please complete for those who will occupy the apartment (Applicant/Co-applicant/Children/Other)
1. |
__________________ __________________ ______ ___________ ______________ _____________ |
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Last |
First |
M.I. |
D.O.B. |
Applicant |
SS# |
2. |
__________________ __________________ ______ ___________ ______________ _____________ |
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Last |
First |
M.I. |
D.O.B. |
Relationship |
SS# |
3. |
__________________ __________________ ______ ___________ ______________ _____________ |
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Last |
First |
M.I. |
D.O.B. |
Relationship |
SS# |
4. |
__________________ __________________ ______ ___________ ______________ _____________ |
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Last |
First |
M.I. |
D.O.B. |
Relationship |
SS# |
5. |
__________________ __________________ ______ ___________ ______________ _____________ |
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Last |
First |
M.I. |
D.O.B. |
Relationship |
SS# |
6. |
__________________ __________________ ______ ___________ ______________ _____________ |
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Last |
First |
M.I. |
D.O.B. |
Relationship |
SS# |
Present Address ______________________________ |
______________________ |
_______ |
____________ |
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Street |
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City |
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State |
Zip Code |
Former Address ______________________________ |
______________________ |
_______ |
____________ |
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Street |
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City |
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State |
Zip Code |
Present Phone Residence ____________________________________________________________________
No. of Autos _________ Reg. of Auto No. 1 __________________ Reg. of Auto No. 2 __________________
No. of Pets ___________ Type _______________________________________________________________
In Case of Emergency Notify (Name) __________________________________________________________
Address ______________________________________________________ Phone _____________________
Are there any special accommodations that the household will require in order to enjoy equal opportunity to use and enjoy the apartment? (e.g. – unit for mobility impaired/unit for visually impaired/unit for hearing impaired/grab bars)
Check One: 
YES
NO |
If yes – you will be required to complete a Request for Reasonable Accommodation. |
RESIDENCY & EMPLOYMENT: |
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Own: Date of Current Occupancy from _____ _____ To: _____ _____ |
$____________________ |
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Month |
Year |
Month |
Year |
Monthly Mortgage Payments |
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Rent: Date of Current Occupancy from _____ _____ To: _____ _____ |
$____________________ |
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Month |
Year |
Month |
Year |
Monthly Rental Payments |
If Rents ___________________________ |
__________________________________ |
__________________ |
Present Landlord Name |
Address |
Phone |
If Rents ___________________________ |
__________________________________ |
__________________ |
Former Landlord Name |
Address |
Phone |
Currently Employed by _______________________________________ Occupation ____________________
Address __________________________________________________________________________________
Length of Employment _____________ Supervisor ________________________ Phone _______________
Annual Gross Salary _________________________ Other (Comm/Bonus) ___________________________
Other Source of Income (i.e. social security/retirement fund/disability/workmans compensation/pension/alimony or child
support/investments/etc.)
Type _______________ Amount ________________ Type _______________ Amount _______________
Type _______________ Amount ________________ Type _______________ Amount _______________
Former Employer ___________________________________________ Occupation ____________________
Address _______________________________________________ Dates of Employment ________________
Supervisor _____________________________________________ Phone ____________________________
BANKING INFORMATION:
Bank – Checking Account _________________ Branch Address __________________ Checking Account No. _________________
Bank – Savings Account _________________ Branch Address __________________ Savings Account No. _________________
Bank – Cert. of Dep. _____________________ Branch Address __________________ C.D. Account No. _____________________
APPLICANTS TERMS (Applicant Read Carefully)
This application is for Apartment No. __________________________ or similar type of occupancy on ________________ (date).
The Applicant warrants and represents that all statements herein are true and promises to execute – upon presentation – a lease in the usual form and on the terms and conditions stated therein.
The Applicant hereby grants permission to carry out necessary credit checks to verify the information contained in the application. Furthermore – applicant understands that an investigative consumer report will be obtained which may include information about personal character and criminal records. Applicant agrees that the information set for on the application is true and complete – and any misrepresentation on this application will constitute a default under the lease or Rental Agreement between the parties.
The deposit taken with this application is to be applied to the Security Deposit. If the applicant fails to execute a lease – then the deposit shall be retained by the owner as liquidated damages. However – the owner will refund the deposit if he rejects this application.
A breach of the above warranty regarding the veracity of any statements made herein releases the owner from all obligations and liabilities arising from either this agreement or a subsequent lease. This application and deposit are taken subject to previous applications and shall be acted upon within 10 days.
The rental agent is only authorized to show the apartment for rent and has no authority to make any representations concerning the premises.
Deposit with Application ____________________
Dated ___________________________________
Agent’s Signature__________________________ |
Applicant’s Signature __________________________ |
