Name: *

First Name

Last Name

Phone: *

(###)

###

####

Birthdate: *

MM

DD

YYYY

Present Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Landlord's Phone Number: *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Person: *

First Name

Last Name

Employer Phone Number: *

(###)

###

####

Reference Name: *

First Name

Last Name

Reference Number: *

(###)

###

####

Reference Name: *

First Name

Last Name

Reference Number: *

(###)

###

####

Have you ever filed for bankruptcy? *

Yes

No

Have you ever been served an eviction notice or asked to vacate a property? *

Yes

No

Have you ever willfully or intentionally refused to pay rent when due? *

Yes

No

Have you ever been sued for unlawful detainer? *

Yes

No

Have you ever been convicted of a felony? *

Yes

No

If available, would like a reserved garage parking space for an add'l fee? *

Yes

No

If available, would like a storage unit for an add'l fee. *

Yes

No

Pet Type: *

Dog

Cat

Other

Privacy Policy: *

IMPORTANT NOTICE REGARDING PRIVACY Policies & Practices with Respect to Disclosing Nonpublic Information Most of the non-public personal information we collect about you comes directly from you on applications and other forms. We also collect additional information from other outside sources as may be necessary to complete your transaction. Outside sources may include, but is not limited to, agents, employers, credit reporting agencies, insurance companies and other financial institutions. The types of information we collect may include your address, phone number, Social Security Number, family information, credit history, background information, other financial information, and insurance policy information. We may disclose any non public personal information we collect about you as permitted or required by law. We may also disclose non-public personal information to affiliated and nonaffiliated third parties as permitted by law. Examples of such third parties are various service agencies, agencies with whom we have joint marketing agreements and government agencies as required by law. Disclosures may be made while you are a consumer, customer, or former customer. We restrict access to non-public personal information about you to those employees, agents, representatives or third parties who need to know the information to provide products and services to our customers. We have policies and procedures that give direction to our employees and agents and representatives acting on our behalf, regarding how to protect and use non-public personal information. We maintain the necessary physical, electronic and procedural safeguards to protect non-public personal information as required by law. By clicking “I ACKNOWLEDGE”, below, I acknowledge I have read this privacy policy. By clicking “Print” you may print a copy of this privacy policy for your records.

I ACKNOWLEDGE THE ABOVE PRIVACY AGREEMENT