FIELDSTONE MANAGEMENT RENTAL APPLICATION
APPLYING AT: AUTUMN PARK APARTMENTS MOVE-IN DATE:
APPLICANT/SPOUSE
(Unmarried Applicants, Please Fill Out Separate Applications)
NAME(S): SOCIAL SECURITY NO.: DATE OF BIRTH:
- - / /
- - / /
The Following Persons Will Also Occupy The Above Apartment: (Name, Relationship, and Age)
RESIDENCE:
Current Address:
City:
State: Zip Code:
Phone:
(Rent-Own-Other) Dates: to
Landlord/Mortgage Co.: City: Phone:
Rent/Mortgage Payment: $
Reason For Leaving:
Previous Address:
City:
State: Zip Code:
Phone: (Rent-Own-Other) Dates: to
Landlord/Mortgage Co.:
City: Phone:
Rent/Mortgage Payment: $
Reason For Leaving:
EMPLOYMENT:
Present Employer:
Address: City: State:
Income: $
wk/mo/yr Position: Phone:
Supervisor: Dates: to
Previous Employer:
Address: City: State:
Income: $
wk/mo/yr Position: Phone:
Supervisor:
Dates: to
Spouse’s Employer: Address: City: State:
Income: $ wk/mo/yr Position: Phone:
Supervisor:
Dates: to
Additional Income: $ wk/mo/yr Source:
CREDIT REFERENCE:
Credit Cards/Loans Account Number Monthly Payments
$
$
Have you ever been evicted from an apartment? YES/NO
Have you ever been in breach of a rental or mortgage agreement? YES/NO
Have you ever filed for bankruptcy? YES/NO If yes, when
Do you currently have any negative credit accounts for loans? YES/NO
Do you pay child support? YES/NO If yes, what is the amount you pay? $ wk/mo/yr
BANKING HISTORY:
Bank Name: Checking Account No.:
Address:
Savings Account No.:
Make of Auto: Year: Driver’s License No.:
License Plate No.:
State: Making Payments To: Monthly Amt.: $
Nearest Relative (To Be Contacted In Case Of Emergency): How Related?
Address: Phone:
LEASE INFORMATION:
Beginning Date: Ending Date: Move In Date:
Size of Apt: Monthly Rent: Sewer:
Holding Fee: $200.00
Leasing Specialist:
In the event the rental application is approved, the owner or agent will apply the deposit of $200.00 toward the first month’s rent. If the application is approved, but the
undersigned chooses not to and/or does not enter into the lease within two (2) weeks of approval, the deposit will be forfeited as liquidated damages incurred by the owner as a
result of not having been able to rent the apartment to another party during this time, unless otherwise agreed to in writing. Upon rejection of the application, the undersigned
will be refunded the full holding fee.
APPLICANT(S) certifies and represents that all information on this application is correct; that he/she is not breaking his/her lease, that he/she has paid his/her rent/mortgage
payments in a timely fashion; that he/she has received no notices of Lease Termination or Eviction; that he/she has not filed for bankruptcy within the past five (5) years, and is
presently financially solvent; and that no adverse credit information is on record. APPLICANT(S) hereby understands that the discovery of any negative rental/mortgage, credit
or financial information or providing any false information is reason for denial. A non-refundable charge of $50.00
will be retained for credit check purposes.
APPLICANT(S) authorizes LESSOR and/or CAVALIER PROPERTY SERVICES, INC. to verify the accuracy of all statements in this application, and also authorizes all
employers, present and previous landlords, and creditors to release all information concerning applicant or applicant’s account(s) for the purpose of verifying this application and
determining applicant’s ability to afford the contractual obligations of the lease. Applicant releases all persons delivering this information from any inadvertent error.
I agree that a signed lease agreement, along with the security deposit equal to one month’s rent, is due within 14 days after the application has been approved. I also agree that
first month’s rent and security deposit are due at the time the lease is signed.
APPLICANT SIGNATURE:
DATE:
APPLICANT SIGNATURE:
DATE: