SILVER PINES APARTMENTS
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- Bartholomew Shelton
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1 SILVER PINES APARTMENTS PHONE: (810) FAX (810) RENTAL APPLICATION--- PLEASE COMPLETE ALL REQUESTED INFORMATION Interested In: 1 Bedroom 2 Bedroom Desired Move In Date: / / PERSONAL INFORMATION Full Name: Date of Birth: / / Social Security Number: - - Driver s License Number: Phone Number: - - Alternate Phone Number: - - Other Residents Under 18 Years Old Relationship Age Pets: Yes No Name: Type: Breed: Name: Type: Breed: How Did You Hear About Us: RESIDENCE HISTORY Current Address: City: State: Zip: Dates of Residency: / / - / / Monthly Rent/Mortgage: $ Landlord or Mortgage Holder: Phone Number: - - Reason for Moving: Previous Address: City: State: Zip: Dates of Residency: / / - / / Monthly Rent/Mortgage: $ Landlord or Mortgage Holder: Phone Number: - - Reason for Moving: 1
2 EMPLOYMENT INFORMATION Current Employer: Position Held: Phone Number: - - Supervisor: Earnings: $ per Employed From: / / - / / Previous Employer: Position Held: Phone Number: - - Supervisor: Earnings: $ per Employed From: / / - / / Reason for Leaving: Other Income Source: Amount: $ per BANKING AND CREDIT REFERENCES Account Type: Checking Savings Credit Card Bank: Branch: Phone Number: - - Account Number: Account Type: Checking Savings Credit Card Bank: Branch: Phone Number: - - Account Number: Account Type: Checking Savings Credit Card Bank: Branch: Phone Number: - - Account Number: 2
3 OTHER INFORMATION Number of Vehicles on Property: Year: Color: Make: Model: License: Year: Color: Make: Model: License: Year: Color: Make: Model: License: Emergency Contact: Relationship: Phone Number: - - Have you ever been evicted from an apartment or broken a lease agreement? Yes No If yes, please explain: Have you ever been convicted of or plead guilty or no contest to a felony or a misdemeanor? Yes No If yes, please explain: 3
4 The applicant hereby authorizes Fountainhead Properties to conduct a credit check and criminal background check, which includes but is not limited to obtaining a credit report, a criminal background report, and interviewing applicant s references and/or previous landlords. The applicant authorizes any individuals listed on this application to speak with Fountainhead Properties representatives regarding the applicant. Applicant further releases any and all individuals who provide information to Fountainhead Properties from any and all claims which applicant may have resulting from information provided to Fountainhead Properties. The applicant also authorizes the release of information based upon photocopies or facsimiles. Applicant agrees that Fountainhead Properties reserves the right to update the criminal background check both prior to taking possession of the premises and upon lease renewal. Fountainhead Properties may withdraw its offer of residency if updated background checks indicate that Applicant no longer meets the current criteria for residency. The applicant agrees to pay a non-refundable application fee of $25.00 per applicant, and a $ holding deposit at the time of applying. The $ holding deposit will not be refunded should the applicant cancel his/her application. The $ holding deposit will go towards the applicant s move in costs, should he/she be approved. If application is denied, the $ holding deposit will be refunded. The undersigned applicant certifies that the above information is true and correct and hereby authorizes a verification of the same. Any false information in the application shall lead to rejection of your application or the immediate termination of your lease and the forfeiture of the $ holding deposit. Applicant Date: 4
5 Request for Employment Verification ****PLEASE ONLY FILL OUT THE TOP PORTION OF THIS FORM IF YOU CAN NOT PROVIDE 2 MONTHS OF CURRENT PAYSTUBS**** Applicant Name: Employer: Employer Address: Employer Phone: Employer Fax: I authorize the release of the information below. Applicant Signature Date Employer Information The individual listed above is employed: Currently No Longer Never Date of Hire: Date of Termination: Reason: Job Title: Type of Employment: Full-Time Part-Time Temporary Hours Worked Per Week: Salary: $ Hourly Weekly Bi-Weekly Annually Verification Completed By: Signature: Title: Date: Please fax this form back to or scan and to Your cooperation and expedient return is greatly appreciated! Please call with any questions. Thank you! 5
6 Request for Rental Verification ****PLEASE ONLY FILL OUT THE TOP PORTION OF THIS FORM IF YOU ARE A CURRENT LEASE HOLDER WITH ANOTHER RENTAL PROPERTY**** Applicant Name: Address Being Verified: Landlord: Phone: Fax: I authorize the release of the information below. Applicant Signature Date Landlord Information Date of Move In: Lease Expiration Date: Number of Late Payments in Past 24 Months (if applicable): Was/Is This Applicant Being Evicted? Did the Applicant Leave Their Unit in Acceptable Condition? Date of Move Out: Sufficient Notice Given? Reason: Does the Applicant Have an Outstanding Balance? Amount: $ Verification Completed By: Signature: Title: Date: Please fax this form back to or scan and to Your cooperation and expedient return is greatly appreciated! Please call with any questions. Thank you! 6
7 7
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