Wilson Manor — Rental Application

Personal Information

First Name

Middle Name

Last Name

Date of Birth

Social Security #

Driver’s License #

Email Address

Other Names Used in the Past

Home Phone

Cell Phone

Other Proposed Occupants

List all other people who will reside in the apartment (other than yourself).

Full NameDate of BirthRelationship to Applicant

Rental / Residence History

Current Residence

Street Address

City

State & Zip

Last Rent Amount

Dates of Residency

Owner / Manager Name & Phone

Name(s) Utilities Are Billed Under

Reason for Leaving

Previous Residence

Street Address

City

State & Zip

Last Rent Amount

Dates of Residency

Owner / Manager Name & Phone

Name(s) Utilities Were Billed Under

Reason for Leaving

Prior Residence

Street Address

City

State & Zip

Last Rent Amount

Dates of Residency

Owner / Manager Name & Phone

Name(s) Utilities Were Billed Under

Reason for Leaving

Employment History

Current Employment

Employed By

Address

Employer’s Phone

Occupation / Title

Name of Supervisor

Monthly Gross Pay

Dates of Employment

Previous Employment

Employed By

Address

Employer’s Phone

Occupation / Title

Name of Supervisor

Monthly Gross Pay

Dates of Employment

Prior Employment

Employed By

Address

Employer’s Phone

Occupation / Title

Name of Supervisor

Monthly Gross Pay

Dates of Employment

Credit History

Account TypeBank / Institution NameBalance on Deposit or Owed

Savings Account

Checking Account

Credit Card

Auto Loan

Vehicles

Include all vehicles belonging to proposed occupants.

MakeModelColorYearLicense Plate

References & Emergency Contacts

By signing this application you grant us permission to communicate with the contacts listed below in the event we cannot locate you. Furthermore, if you abandon the apartment for any reason, you give us permission to allow your listed relative to remove all contents of the dwelling on your behalf.

Doctor

Name

Street Address

City

State & Zip

Phone

Lawyer

Name

Street Address

City

State & Zip

Phone

Nearest Relative (living elsewhere)

Name

Street Address

City

State & Zip

Phone

General Information

Have you ever been served a late rent notice?

No Yes

Have you ever filed for bankruptcy?

No Yes

Have you ever been served an eviction notice?

No Yes

Have you ever been convicted of a felony?

No Yes

Have you had any rent problems with your current apartment or landlord?

No Yes

Have you been a party to a lawsuit in the past?

No Yes

Why are you moving from your current address?

When would you be able to move in?

How long do you plan to stay?

Do any proposed occupants smoke?

No Yes

Pets — List breed, approximate weight, and age for each

$50/month per dog · No cats · 40 lb weight limit · Photo & proof of vaccines required upon approval

Additional verifiable income sources (optional)

If you ran into financial difficulty, is there someone who could loan you rent money? If so, provide their name, address, and phone number.

We may run a credit and criminal background check. Anything you’d like to comment on?

How did you hear about this apartment?

Know anyone else looking for an apartment? (Referrals earn a reward!)

Agreement & Authorization

I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification of information I provided, and communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for an apartment and does not constitute a rental or lease agreement in whole or part. I further understand that there is a non-refundable fee to cover the cost of processing my application and I am not entitled to a refund even if I don’t get the apartment. Any questions regarding rejected applications must be submitted in writing and accompanied by a self-addressed stamped envelope.

Signature (draw with mouse or finger)

Sign here

Date

By clicking Submit Application you confirm that all information provided is accurate and you authorize JimKev Realty to run a credit and background check.