Application

Desired Date of Occupancy *

Application For *

Which Property Are You Applying For? *

Enter the name of the apartments or address of the property you are applying for.

PERSONAL INFORMATION

Your Name *

First

Last

Date of Birth *

Social Security Number *

Driver License State & No. *

Phone *

Email *

How many others will be occupying this unit

Selected Value: 0

Other Occupants

Full Name

Relationship to you:

Date of Birth

How many pets do you or other occupants own?

What type of pet?

How did you hear about our property?

Do you speak any foreign languages fluently?

Do you have any additional sources of income?

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RESIDENCE HISTORY

Present Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Date of Move-in

Present Landlord/Mortgage Company

Phone

Monthly Payment: *

Reason for Moving:

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Date of Move-in

Date of Move-out

Landlord/Mortgage Company

Phone

Monthly Payment

Reason for Moving

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EMPLOYMENT HISTORY

Present Employer *

From

Employer Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Position Held *

FT/PT?

Gross Monthly Salary

Previous Employment

Previous Employer:

From

To

Previous Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Position Held

FT/PT?

Gross Monthly Salary

Spouse's Employment

Spouse’s Present Employer

From

To

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Spouse Position Held

Spouse FT/PT

Spouse Gross Monthly Salary

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OTHER INFORMATION

How many vehicles are owned by you and all others to occupy unit?

Selected Value: 0

Vehicles

Year/Make/Model

Color

Plate No./State

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EMERGENCY CONTACT INFORMATION

Emergency Contact Name #1 *

First

Last

Relationship to you

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact Name #2 *

First

Last

Relationship to you

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

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DECLARATIONS

Are there any outstanding judgments against you?

Applicant Y/N *

Co-Applicant Y/N

Have you ever been convicted of a criminal offense?

Applicant Y/N *

Co-Applicant Y/N

Have you ever been evicted?

Applicant Y/N *

Co-Applicant

Have you ever received an unlawful detainer?

Applicant Y/N *

Co-Applicant Y/N

Have you declared bankruptcy within the past 7 years?

Applicant Y/N *

Co-Applicant Y/N

Do you owe any rental agencies/landlords money?

Applicant Y/N *

Co-Applicant Y/N

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ACKNOWLEDGMENT AND NOTIFICATION TO APPLICANT

I understand I acquire no rights in any property until I sign this agreement and submit a holding fee in the form of a cashier’s check or money order only, for the amount of the particular security deposit for that unit. If my application is approved and I sign a Rental Agreement this holding fee shall be credited to my security deposit. If my tenancy is approved but I DO NOT sign a Rental Agreement and move-in the holding fee shall be forfeited to the owner as liquidated damages. I understand I must pay a NON-REFUNDABLE APPLICATION FEE ($51.50 Single Adult or $77.25 Married Couple) for screening my application made payable to JCHiggins & Associates. If this application is denied because of adverse credit findings I may contact TRANSUNION at (800) 888-4213. I/We hereby authorize JCHiggins & Associates to immediately obtain such credit reports, verifications of income and of rental and employment histories and criminal background checks. I/We further understand that false, fraudulent or misleading information disclosed above may constitute grounds for rejection of this application, termination of rights of occupancy, and/or forfeiture of deposits/holding fee and may constitute a criminal offense under the laws of this STATE. We do not accept a comprehensive reusable tenant screening report.

Applicant Signature *

Clear Signature

Co-Applicant Signature

Clear Signature

Date *

PayPal Commerce *

Card Number

Expiration Date

Security Code

Card Holder Name

PLEASE COMPLETE ALL REQUESTED INFORMATION BELOW

$51.50 SINGLE APPLICATION FEE

$77.25 JOINT APPLICATION FEE

PERSONAL INFORMATION

Other Occupants

RESIDENCE HISTORY

EMPLOYMENT HISTORY

Previous Employment

Spouse's Employment

OTHER INFORMATION

Vehicles

EMERGENCY CONTACT INFORMATION

DECLARATIONS

ACKNOWLEDGMENT AND NOTIFICATION TO APPLICANT