THE PALMS AT ATLANTIS HOA, INC. C/O CMC Management, Inc Jog Road Greenacres, FL ~ Fax

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1 THE PALMS AT ATLANTIS HOA, INC. C/O CMC Management, Inc Jog Road Greenacres, FL ~ Fax APPLICATION FOR OCCUPANCY *(Please check one) Application for PURCHASE or RENTAL of # Palm Circle Desired date of closing or occupancy Closing Date if purchase: Buyer/Renter Name(s): Phone Phone PLEASE INCLUDE THE FOLLOWING WITH YOUR APPLICATION: Check or money order for $ made payable to The Palms at Atlantis for application fee per person or married couple. A separate application should be made for all perspective owners & renters over the age of 18 Check or money order for $60.00 made payable to CMC Management for processing fee Copy of Driver s License(s) Copy of Purchase contract or proposed lease AFTER CLOSING IT WILL BE NECESSARY TO PROVIDE THE MANAGEMENT COMPANY WITH A COPY OF THE WARRANTY DEED and MAILING ADDRESS ALL APPLICATIONS MUST BE FILLED OUT COMPLETELY OR WILL NOT BE PROCESSED YOU MUST CONTACT THE MANAGEMENT COMPANY FOR AN INTERVIEW PRIOR TO APPROVAL PLEASE DO NOT FAX APPLICATION For Purchase Maintenance Fees are due the first day of each quarter January 1, April 1, July 1, October 1

2 THE PALMS AT ATLANTIS HOMEOWNERS ASSOCIATION UNMARRIED CO-APPLICANTS USE SEPARATE APPLICATION Date Home Phone Desired Date Of Occupancy Apt. No. Bldg. No. Purchase OR Lease Name SS # - - DOB / / Last First MI Jr/Sr Prior Spouse SS # - - DOB / / Last First MI Jr/Sr. Prior Other SS # - - DOB / / Last First MI Jr/Sr. Prior Occupants SS # - - DOB / / Present Address Street Apt # City State Zip Code Present Landlord or Mortgage Co Phone ( ) Length of Residence: / TO / Monthly Rent/Mort$ #Pets Type Weight Mo Yr. Mo. Yr. Previous Landlord Phone( ) Length of Residence / TO / Monthly Rent $ Military Status: ACTIVE? YES NO Present Employer City & St. PH ( ) Position Dates Employed / TO / Income $ per Previous Employer City & St. PH ( ) Position Dates Employed / TO / Income $ per Spouse Present Employer City & St PH ( ) Position Dates Employed / TO / Income $ per In Case of Emergency Notify ( ) Name Relationship Address Phone Number Vehicle #1 #2 Year Make Model Tag # State Year Make Model Tag # State Have you ever left owing money to an owner or landlord? Applicant: Yes No Spouse: Yes No Have you ever been arrested for a felony? Applicant: Yes No Spouse: Yes No Have you ever been convicted of a felony? Applicant: Yes No Spouse: Yes No If you have answered yes to any of the above questions, please explain the circumstances regarding the situation on back of this sheet. AUTHORIZATION OF RELEASE OF INFORMATION: Applicant(s) represents that all of the above information and statements on the application for rental are true and complete, and hereby authorizes verification of any and all information relating to residential history (rental or mortgage), employment history, criminal history records, court records, and credit records. This application must be signed before it can be processed by management. Applicant acknowledges that false or omitted information herein may constitute grounds for rejection of this application, termination of right of occupancy, and/or forfeiture of fees or deposits and may constitute a criminal offense under the laws of this State. NON-REFUNDABLE APPLICATION. No oral agreements have been made. Applicant s Signature Date Spouse s Signature Date

3 WTC BACKGROUNDS, INC. We re The Choice! ACTION REQUEST X RENTAL HISTORY (Criminal, Credit & Eviction) Criminal History Statewide (FL) Criminal History/Out of State Civil Record by State Driving Records/History (MUST HAVE DL # FDLE Workers Comp Record SSN Verification Credit Report Sexual Offender Search NAME FIRST MI ADDRESS DOB SEX RACE SSN D.L.# COMPANY: _PALMS AT ATLANTIS HOA, INC DATE Applicant Release In connection with for employment and or residency, I understand that investigative background inquiries are to be made on me including consumer credit, criminal conviction, motor vehicles, and other reports. Further I understand that WTC Backgrounds, Inc. will be requesting information from various State and other agencies which maintain records about my history. These records include but not limited to driving, credit criminal, and civil history. I authorize any party or agency contacted by WTC Backgrounds Inc. to furnish the above mentioned information and release all parties involved from liability and responsibility for doing so. This authorization and consent shall be valid in original, fax, or copy form. Applicant Signature Date

4 WTC BACKGROUNDS, INC. We re The Choice! ACTION REQUEST X RENTAL HISTORY (Criminal, Credit & Eviction) Criminal History Statewide (FL) Criminal History/Out of State Civil Record by State Driving Records/History (MUST HAVE DL # FDLE Workers Comp Record SSN Verification Credit Report Sexual Offender Search NAME FIRST MI ADDRESS DOB SEX RACE SSN D.L.# COMPANY: _PALMS AT ATLANTIS HOA, INC DATE Applicant Release In connection with for employment and or residency, I understand that investigative background inquiries are to be made on me including consumer credit, criminal conviction, motor vehicles, and other reports. Further I understand that WTC Backgrounds, Inc. will be requesting information from various State and other agencies which maintain records about my history. These records include but not limited to driving, credit criminal, and civil history. I authorize any party or agency contacted by WTC Backgrounds Inc. to furnish the above mentioned information and release all parties involved from liability and responsibility for doing so. This authorization and consent shall be valid in original, fax, or copy form. Applicant Signature Date

5 THE PALMS AT ATLANTIS HOA, INC. c/o Century Management Consultants, Inc Jog Road Greenacres, FL ~ Fax CERTIFICATE OF APPROVAL FOR SALE OR LEASE This is to certify that Has/have been approved by The Palms at Atlantis Homeowners Association, Inc. as purchaser(s)/renter(s) of the following described property in Palm Beach County Florida: Address: Dated this day of 20 By: Signature: Title:

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