Lease Application

Applicant 1




Applicant 2




Other Occupants

Emergency Contacts

Personal

(Landlord is not responsible for either)

Rental History

Has any applicant been evicted or asked to move out?
Has any applicant broken a rental agreement or lease?
Has any applicant been sued for non-payment of rent or damage to property?

Terms & Payment

Applicant will deposit $200.00 with Landlord's Agent to reserve an apartment pending credit and reference approval.

  • $100.00 is a non-refundable fee for processing of credit and criminal background check ("Processing Fee")
  • $100.00 (the "Balance") shall be applied as specified below
    • If Applicant cancels this application in writing within 3 days after the date of this application, the Balance shall be returned to Applicant
    • If Landlord rejects the application, the Balance shall be returned to Applicant.
    • If Landlord accepts the application, the Balance shall be applied toward the security deposit.

In all other circumstances, Landlord shall retain the Balance as liquidated damages and shall have no further obligations to Applicants. Applicant understands that this application involves no obligations on the part of Owner or its agent to approve this application or to deliver occupancy of the above premises. Any sums received hereafter but prior to Applicant taking posession shall be added to the Balance and applied pursuant to the above terms.

Applicant consents to agent running credit and criminal background check for use in evaluating whether applicant qualifies to be a tenant.
Payment Method

Payment Information








Security Code: For VISA, MasterCard and Discover your security code is the 3 digit number printed on the back of your credit card. For American Express it is the 4 digit code on the front of your card.




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