Rental Application for Residents and Occupants Each co-applicant and each occupant 18 years old and over must submit a separate application. Spouses may submit a single application. Date when filled out: ABOUT YOU Full name (exactly as on driver's license or govt. ID card) Your street address (as shown on your driver's license or government ID card): Driver's license # and state: OR govt. photo ID card #: Former last names (maiden and married): Your Social Security #: Birthdate: Height: Weight: Sex: Eye color: Hair color: Marital Status:  single  married  divorced  widowed  separated Are you a U.S. citizen?  Yes  No Do you or any occupant smoke?â yes  no Will you or any occupant have an animal?  yes  no Kind, weight, breed, age: Current home address (where you now live): Home/cell phone: ( ) Current rent: $ Email address: Name of apartment where you now live: Current owner or manager's name: Their phone: Date moved in: Why are you leaving your current residence? Your previous home address: Apartment name: Name of above owner or manager: Their phone: Previous monthly rent: $ Date you moved in: Date you moved out: YOUR WORK Present employer: Your gross annual income is over: $ Date you began this job: Supervisor's name and phone: Previous employer: Gross annual income was over: $ Dates you began and ended this job: Previous supervisor's name and phone: YOUR CREDIT HISTORY Your bank's name, city, state: List major credit cards: Other non-work income you want considered. Please explain: YOUR RENTAL/CRIMINAL HISTORY Check only if applicable. Have you, your spouse, or any occupant listed in this Application ever:  been evicted or asked to move out?  moved out of a dwelling before the end of the lease term without the owner's consent?  declared bankruptcy?  been sued for rent?  been sued for property damage?  been charged, detained, or arrested for a felony, misdemeanor involving a controlled substance, violence to another person or destruction of property, or a sex crime that was resolved by conviction, probation, deferred adjudication, court ordered community supervision, or pretrial diversion?  been charged, detained, or arrested for a felony, misdemeanor involving a controlled substance, violence to another person or destruction of property, or a sex crime that has not been resolved by any method? Please indicate below the year, location and type of each felony, misdemeanor involving a controlled substance, violence to another person or destruction of property, or sex crime other than those resolved by dismissal or acquittal. We may need to discuss more facts before making a decision You represent the answer is "no" to any item not checked above. YOUR SPOUSE Full name: Former last names (maiden and married): Spouse's Social Security #: Driver's license # and state: OR govt. photo ID card #: Birthdate: Height: Weight: Sex: Eye color: Hair color: Are you a U.S. citizen?  Yes  No Present employer: Date began job: Gross annual income is over: $ Supervisor's name and phone: OTHER OCCUPANTS Names of all persons under 18 and other adults who will occupy the unit without signing the lease. Continue on separate page if more than three. YOUR VEHICLES List all vehicles owned or operated by you, your spouse, or any occupants (including cars, trucks, motorcycles, trailers, etc.). Continue on separate page if more than three. EMERGENCY Emergency contact person over 18, who will not be living with you: Home phone: ( ) Past credit problems you want to explain. (Use separate page.) AUTHORIZATION I or we authorize (owner's name) WHY YOU APPLIED HERE Were you referred?  Yes  No. If yes, by whom: Name of locator or rental agency: Name of individual locator or agent: Name of friend or other person: Did you find us on your own?  Yes  No If yes, fill in information below:  On the Internet  Stopped by  Newspaper (name):  Rental publication:  Other: to obtain reports from any consumer or criminal record reporting agencies before, during, and after tenancy on matters relating to a lease by the above owner to me and to verify, by all available means, the information in this application, including criminal background information, income history and other information reported by employer(s) to any state employment security agency. Work history information may be used only for this Rental Application. Authority to obtain work history information expires 365 days from the date of this Application. Applicant's signature Spouse's signature Applicant must also sign on the next page of this Application. 2011, National Apartment Association, Inc. - 5/2011 Page 1 of 2
The Florida Apartment Association Lease Contract to be used must be the latest version published by the association unless an earlier version is initialed by resident(s) and attached to this Application. The blanks in the Lease Contract will contain the following information: Names of all residents who will sign Lease Contract Name of Owner/Lessor Property name and type of dwelling (bedrooms and baths) Complete street address City/State/Zip Names of all other occupants not signing Lease Contract (persons under age 18, relatives, friends, etc.) Total number of residents and occupants Beginning date and ending date of Lease Contract Total security deposit $ Animal deposit $ Other fees $ Total monthly rent for dwelling unit $ Contemplated Lease Contract Information To be filled in only if the Lease Contract is not signed by resident(s) at time of application for rental. Rent to be paid at (check one)  on-site manager's office or  at 1. Lease Contract Information. The Lease Contract contemplated by the parties is attached or, if no Lease Contract is attached, the Lease Contract will be the current Lease Contract noted above. Special information and conditions must be explicitly noted on an attached Lease Contract or in the Contemplated Lease Contract Information above. 2. Application Fee (nonrefundable). You have delivered to our representative an application fee in the amount indicated below, and this payment partially defrays the cost of administrative paperwork. It's nonrefundable. 3. Application Deposit (may or may not be refundable). In addition to any application fee, you have delivered to our representative an application deposit in the amount indicated below. The application deposit is not a security deposit. However, it will be credited toward the required security deposit when the Lease Contract has been signed by all parties OR it will be refunded under paragraph 10 if you are not approved OR it will be retained by us as liquidated damages if you fail to sign or attempt to withdraw under paragraph 6 or 7. 4. Approval When Lease Contract Is Signed in Advance. If you and all co-applicants have already signed the Lease Contract when we approve the Application, our representative will notify you (or one of you if there are co-applicants) of our approval, sign the Lease Contract, and then credit the application deposit of all applicants toward the required security deposit. 5. Approval When Lease Contract Isn't Yet Signed. If you and all coapplicants have not signed the Lease Contract when we approve the Application, our representative will notify you (or one of you if there are co-applicants) of the approval, sign the Lease Contract when you and all co-applicants have signed, and then credit the application deposit of all applicants toward the required security deposit. 6. If You Fail to Sign Lease Contract After Approval. Unless we authorize otherwise in writing, you and all co-applicants must sign the Lease Contract within 3 days after we give you our approval in person or by telephone or within 5 days after we mail you our approval. If you or any co-applicant fails to sign as required, we may keep the application deposit as liquidated damages, and terminate all further obligations under this Agreement. 7. If You Withdraw Before Approval. You and any co-applicant may not withdraw your application or the application deposit. If you or any coapplicant withdraws an Application or notifies us that you've changed your mind about renting the dwelling unit, we'll be entitled to retain all application deposits as liquidated damages, and the parties will then have no further obligation to each other. Application Agreement Prorated rent for:  first month orâ second month $ Monthly rental due date Late charges due if rent is not paid on or before the Initial late charge $ Daily late charge $ Returned-check charge $ (Check one) :  furnished or  unfurnished Utilities paid by owner (check all that apply):  electricity,  gas,  water,  wastewater,  trash,  cable TV,  master TV antenna You are (check one):  required to purchase personal liability insurance or  not required to purchase personal liability insurance Special provisions regarding parking, storage, etc.: (see attached page if necessary): Completed Application. An Application will not be considered "completed" and will not be processed until all of the following have been provided to us (unless checked):  a separate Application has been fully filled out and signed by you and each co-applicant  an application fee has been paid to us  an application deposit has been paid to us. If no item is checked, all are necessary for the Application to be considered completed. Non-approval. We will notify you whether you've been approved within 10 days after the date we receive a completed Application. Your Application will be considered "disapproved" if we fail to notify you of your approval within 10 days after we have received a completed Application. Notification may be in person or by mail or telephone unless you have requested that notification be by mail. You must not assume approval until you receive actual notice of approval. The 10-day time period may be changed only by separate written agreement. 10. Refund after Non-approval. If you or any co-applicant is disapproved or deemed disapproved under paragraph 9, we'll refund all application deposits within 30 days of such disapproval. Refund checks may be made payable to all co-applicants and mailed to one applicant. 11. Extension of Deadlines. If the deadline for signing, approving, or refunding under paragraphs 6, 9, or 10 falls on a Saturday, Sunday, or a state or federal holiday, the deadline will be extended to the end of the next day. 12. Notice to or from Co-applicants. Any notice we give you or your coapplicant is considered notice to all co-applicants and any notice from you or your co-applicant is considered notice from all co-applicants. 13. Keys or Access Devices. We'll furnish keys and/or access devices only after: (1) all parties have signed the contemplated Lease Contract and other rental documents referred to in the Lease Contract and (2) all applicable rents and security deposits have been paid in full. 14. Receipt. Application fee (nonrefundable): $ Application deposit (may or may not be refundable): $ Other move-in fees (may or may not be refundable): $ Total of above application fee and application deposit: $ Total amount of money we've received to this date: $ 15. Signature. Our representative's signature is consent only to this Application Agreement. It does not bind us to accept applicant or to sign the proposed Lease Contract. Acknowledgment. You declare that all your statements on the first page of this Application are true and complete. You authorize us to verify same through any means. If you fail to answer any question or give false information, we may reject the application, retain all application fees and deposits as liquidated damages for our time and expense, and terminate your right of occupancy. Giving false information is a serious criminal offense. In lawsuits relating to the application or Lease Contract, the prevailing party may recover all attorney's fees and litigation costs from the losing party. We may at any time furnish information to consumer reporting agencies and other rental housing owners regarding your performance of your legal obligations, including both favorable and unfavorable information about your compliance with the Lease Contract, the rules, and financial obligations. If you're seriously ill or injured, what doctor may we notify? (We're not responsible for providing medical information to or calling doctors or emergency personnel.) Doctor's name: Doctor's phone: ( ) Important medical information about you in an emergency: 8. 9.. Applicant's Signature: Signature of Spouse: Signature of Owner's Representative: FOR OFFICE USE ONLY 1. Apt. name or dwelling address (street, city): Unit # or type: 2. Person accepting application: Phone: ( ) 3. Person processing application: Phone: ( ) 4. Date that applicant or co-applicant was notified by  telephone,  letter, or  in person of  acceptance or  nonacceptance: (Deadline for applicant and all co-applicants to sign lease is three days after notification of acceptance in person or by telephone, five days if by mail.) 5. Name of person(s) who were notified (at least one applicant must be notified if multiple applicants): 6. Name of owner's representative who notified above person(s): 2011, National Apartment Association, Inc. Florida/National Apartment Association Official Form B-11, May 2011 Page 2 of 2
APPLICANT AUTHORIZATION RELEASE In connection with my application for residence at I hereby authorize any consumer agency, current and previous employer, current and any former landlord, law enforcement agency, any check authorization agency, and state employment security agency to release all information any of them may have about me to LexisNexis Resident Screening. I hereby release all of these parties from any liability in connection with release of such information. I also authorize the use of LexisNexis data contained in my application for residence for demographically or other types of studies or reports. A facsimile or other copy of this authorization shall be sufficient for release by aforesaid parties. I have submitted a non-refundable fee of $ to process my application for residence. I understand that this sum is not a rental payment or deposit and will not be refunded even if my application is denied or cancelled by me after submission. This authorization is for this transaction only and continues in effect for one (1) year unless limited by state law, in which case the authorization form continues in effect for the maximum period, not to exceed one (1) year, allowed by law. Date Driver s License # Social Security Number Signature Date of Birth (Printed Name) Attachment E
STATEMENT OF RENTAL POLICY Welcome to our community! Prior to completing an application for residency, please read this Statement of Rental Policy to determine whether you meet all rental guidelines. We require all persons over the age 18 that will be residing in the apartment home to complete our full qualification process. There are many choices for housing in our area and you have made a good decision by selecting our community. Please contact a member of our management team if further clarification is needed on our requirements. All applications are evaluated in the same manner and given equal consideration. EQUAL HOUSING OPPORTUNITY: The Worthing Companies/WSE LLC is an equal housing opportunity provider. We believe in the spirit of the Federal Fair Housing Act and this community does not discriminate on the basis of race, color, sex, national origin, religion, disability, or familial status. The Worthing Companies/WSE LLC fully supports and complies with the Federal Fair Housing Act and all local and state laws regarding fair housing. PHOTO IDENTIFICATION: All visitors must present a valid driver's license or other government issued picture identification to tour the community. For verification purposes valid government issued photo identification is required to apply for residency and a copy of your identification will be retained in your resident file. APARTMENT AVAILABILITY: Applications for apartment homes will be accepted on a first come, first serve basis and are subject to the availability of the particular apartment type requested. Availability does not necessarily mean that an apartment will definitely be available for occupancy by an applicant at the estimated date. Available apartments include those where a Notice to Vacate has been submitted by an existing resident indicating an intention to vacate on or about a certain date. Under certain circumstances, we will permit current residents who are not in default of their lease to withdraw or change their notice of intent to vacate. Other circumstances not necessarily under management s control may also delay the date of availability of an apartment. In addition, an apartment may not be considered available because an application has been made and a deposit placed to hold the apartment. If the applicant s credit is not approved or if the applicant fails to sign a Rental Agreement by the specified date, then the apartment would again become available. Whether a particular apartment or type of apartment is available can vary significantly within several hours or a day. Our company seeks to lease its apartment homes at the most competitive rates obtainable in each community s housing market. This is done by comparative pricing, negotiated rents, and pricing incentives to obtain the highest rental income possible for the owners of our properties. There may be price differences as to the effective rental rates obtained by our residents depending on the leasing or marketing program than in effect and the time and date on which they visited the property or applied for residency. You are able to apply to live in any apartment home that is or will be vacant ( available ) during your desired timeframe. SCORING OF YOUR CONSUMER CREDIT REPORT: This community uses an empirically derived, statistically sound, credit scoring system to evaluate your consumer credit report. Credit scoring is based on real data and statistics, so it treats all applicants objectively. Your consumer credit report contains information about you and your credit experiences, such as your bill-payment history, the number and type of accounts that you have late payments, collection actions, outstanding debt, and the age of your accounts. Using a statistical program, this information is compared to the credit performance of other applicants with similar profiles which predicts how likely it is that you will pay your rent in a timely manner and fulfill your other lease obligations. Based upon your credit score, your application will either be accepted, accepted on the condition that an additional security deposit, a minimum, of one month s rent in certified funds be paid, or declined. If your application is declined or is accepted with conditions, you will be given the name, address and telephone number of the consumer reporting agencies that provided your consumer information. An applicant rejected for unsatisfactory credit is encouraged to obtain a copy of the credit report, correct any erroneous information that may be on the report and submit a new application to this community for further consideration. INCOME VERIFICATION: If your application is accepted or accepted with conditions, prior to moving into the community we will require verification of income by presenting your three most current pay stubs. The total monthly combined income must be at least three (3) times the amount of the monthly rent for the home you have chosen. If applicants are self-employed or receive money from non-employment sources, one of the following proofs of income will be required through (I) copies of the previous year s tax returns, (II) a financial statement from a CPA verifying employment and income, or (III) photocopies of your three most current bank statements illustrating the ability to pay rent for three times the monthly rent through the entire lease term. (Other verifiable income may mean, but is not limited to, alimony/child support, trust accounts, social security, grants/loans, etc.). If we are unable to verify your income or your income is contrary to your lease application, our acceptance of your lease application will be withdrawn. SEX OFFENDER REGISTRY: All applicants over the age of 18 who will be occupying an apartment must meet the applicable sex offender registry qualification criteria and consent to a multi-state sex offender registry search. Each of the applicants and occupants over the age of 18 who will be occupying the apartment must score a "pass" on their multi-state sex offender registry search. If your application is rejected based on the discovery of public records that indicate an unacceptable sex offender history, you will be given the name, address and telephone number of the consumer reporting agency that provided the sex offender history report. An applicant rejected based on such sex offender history report, is encouraged to obtain a copy of the report, correct any erroneous information that may be on the report and submit a new application to this community for further consideration. Our policy of performing a multi-state sex offender registry search during the application process does not constitute a representation, warranty, or guaranty that all other residents and occupants living in the apartment community have no sex offender histories. CRIMINAL BACKGROUND HISTORY: All applicants over the age of 18 who will be occupying an apartment must meet the applicable criminal background qualification criteria and consent to a criminal background check. Each of the applicants and occupants over the age of 18 who will be occupying the apartment must score a "pass" on their criminal background check. If your application is rejected based on the discovery of public records that indicate an unacceptable criminal background, you will be given the name, address and telephone number of the consumer reporting agency that provided the criminal background report. An applicant rejected based on such a criminal background report, is encouraged to obtain a copy of the report, correct any erroneous information that may be on the report and submit a new application to this community for further consideration. Our policy of performing criminal background screening during the application process does not constitute a representation, warranty, or guaranty that all other residents and occupants living in the apartment community have no criminal histories. CO-SIGNERS: In the event an applicant is declined based on negative credit or lack of income a co-signer is permitted, the co-signer must complete an application. Cosigners income must be at least three times the amount of the monthly rent of the apartment home chosen and meet other qualifying criteria. A co-signer must sign the lease and all addendums. They will be fully responsible for all sums that come due under the rental agreement, any renewals or extensions and any damages exceeding normal wear and tear if the occupying resident(s) default. OCCUPANCY POLICY: No more than two (2) persons per bedroom or sleeping space shall be permitted to occupy an apartment. A child or infant who is under the age of twelve (12) months (including an unborn child) at the time of leasing or renewing an existing lease will not be counted in determining the maximum number of persons who may occupy an apartment. Residents who have exceeded the occupancy restriction are not required to upgrade (move to a larger apartment) until the end of their current lease or renewal term (not including any month to month automatic renewal extensions). 3/11/2011 Revised Page 1
HOLD HARMLESS ACKNOWLEDGMENT: Applicant agrees that Management does not promise, warrant or guarantee the safety and security of applicant, applicant s family and occupants or applicant s personal property against the criminal actions of other residents or third parties. Furthermore, management shall not be liable for any damage or injury to applicant, applicant s family and occupants or to any person entering the premises or the building of which the apartment is a part, for injury to person or property arising from theft, vandalism or casualty occurring in the premises or the buildings. The term premises is defined to include any common areas, lakes and the surrounding area. Applicant agrees to indemnify and hold harmless management from all claims, costs and expenses arising from injury to person or property. Each applicant has the responsibility to protect him or herself and to maintain appropriate insurance to protect his/her belongings. Applicants should contact an insurance agent to arrange appropriate insurance protecting their personal property. Applicant shall at all times maintain renter s insurance including adequate fire, casualty and liability insurance to insure against the risks described above. Insurance coverage maintained by management does not protect applicant from loss of personal property by theft, fire, water damage and other perils. Applicant is responsible for maintaining appropriate vehicular or automobile insurance coverage. RENTER S INSURANCE: All applicants must secure a renter s insurance policy of $100,000 of general liability coverage and provide written proof of such policy prior to occupying the apartment. The policy must be maintained throughout the entire lease term and any subsequent renewal terms. Written proof of insurance is also required prior to the inception of any renewal agreements. SATELLITE DISH: Management will permit the installation of one (1) satellite dish per apartment in accordance with FCC and local access laws. Not all of our apartments are suitable to satellite reception and we cannot guarantee that satisfactory transmission will be received. There are limitations on how and where a satellite dish can be installed and Management requires that lease holders sign the appropriate satellite dish addendum to the Rental Agreement. Lease holders must pay an additional security deposit prior to the installation of the satellite dish. General liability insurance in the amount of $200,000 is required for any resident opting to install a satellite dish, and a copy of the insurance policy must be provided to Management prior to move-in and maintained throughout the entire period of occupancy at the community. Upon renewal of the lease term an updated copy of the insurance policy must be provided to Management. INTERNATIONAL RENTAL CRITERIA: In addition to qualifying under the terms stated in this Statement of Rental Policy, Applicants from countries other than the United States who do not have a Social Security Number must comply with the following additional conditions: 1. Present an original valid Passport along with an original valid Visa showing raised notary seals on each -- expired Passports or Visas will result in automatic decline of application. 2. International applicants with verifiable employment are required to pay an additional deposit equal to one month s rent in advance by cashier s check or money order. Self-employed/unemployed international applicants with verification of income are required to pay an additional deposit equal to one month s rent in advance by cashier s check or money order. International applicants with no verifiable U.S. rental history, credit, and employment are required to pay an additional deposit equal to two month s rent in advance by cashier check or money order. 3. Acceptable employment verifications are as follows: Employed Applicants: Provide a letter of employment from your employer. The letter is to be on company letterhead, signed, and notarized. Self-Employed or Unemployed Applicants: Provide proof of income from an attorney, accountant, and/or letter from your bank stating sufficient funds. All letters must be on official company, firm and/or bank letterhead, signed, and notarized. 4. All payments will be required in U.S. Certified Funds. FEES/DEPOSITS: Each applicant shall pay a non-refundable application fee for verification of information and credit approval. A security deposit must also be submitted with the application for Residency. Once approved, a portion of the security deposit may also become non-refundable as set forth in the Rental Agreement. If for any reason you cancel your application within 72 hours of the application date or if your application is declined, Management will fully refund your security deposit. If you cancel your application after 72 hours of the application date, Management will retain the security deposit as liquidated damages for the amount of rent lost and any expenses incurred due to the cancellation. VEHICLES: Parking is limited in our community and only one (1) vehicle per lease holder is permitted per apartment home. Boats, trailers, commercial vans and campers are not permitted to be parked on the property at any time except, if available, in designated parking areas only. Written permission from management is required. Unsightly, inoperable or unregistered vehicles are not permitted and may be towed at owner s expense by management. Such unsightly or inoperable vehicles are determined at the sole discretion of management. Each applicant agrees to be bound by and sign all addenda to the lease that pertain to parking rules and regulations. PETS: Pets are prohibited unless applicants comply with the following regulations and obtain management s express written approval. A non-refundable pet fee and/or refundable pet deposit may be due prior to occupying the apartment. Some communities require monthly pet rent be paid in additional to any up-front monies requested. Management will accept animals commonly recognized as domestic pets and non-aggressive or threatening. Pets must be at least one year old and weigh no more than 50 lbs. at maturity (depending on specific property rules and regulations, some communities will have a varying weight limit). I have read the above and understand the basis for consideration of my application for residency. Applicant s Signature Date 3/11/2011 Revised Page 2