Address you are applying for :
          
Date of desired occupancy :
 
Would you like to take advantage of our lease purchase programs?
  Yes No  
How much of a down payment can you raise?:
         
What is the maximum monthly payment you could pay?:
    
How is your credit?:  
  Excellant Good Need a little work

Primary Applicant Information:

Full name (exactly how it appears on your Drivers license):
 
Current home address : Street/City/State/Zip
        
Phone #:
         
Email Address:
    

Co-Applicant Information: (if applicable)

Full name (exactly how it appears on your Drivers license):
 
Current home address : Street/City/State/Zip
        
Phone #:
         
Email Address:
    

General Information:
     
Length At current residence :
            
If renting Apartment complex name/location:
          
Current owner or managers name :
    
Landlords phone # :
   
Current monthly rent:
            
Present Employer :
    
Employer Address: Street/City/State/Zip code:
    
Work phone # :    
      
Position or job title :
    
Date of hire:
  
Supervisors name and phone # :
       
Last Employer (if at current job for less than 2 years):
         
Street address:   
        
City/State/Zip code:
  
Work phone #:
         
Position or job title:
   
Gross monthly income was? :   
         
Dates you began and ended this job :  
          
Supervisors name and phone #:  
    

Income and Expenses:

Gross monthly income (before taxes & deductions) :
       
Other income :
           
Source of other income :  
   
Total of all Debts excluding current rent:
   

Personal References (No relatives or family members)

Reference 1
 Name, Address, Phone Number
Reference 2
 Name, Address, Phone Number
Reference 3
 Name, Address, Phone Number

Authorized and Acknowledged by :
 
Date of application :  
 
Best phone # to reach you during business hours:
  
Best phone # to reach you after hours:
  

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Type any special comments or requests here :
 

By submitting this form I/We understand that this application is preliminary and if the minimum requirements are met a hard copy application will be mailed to me that will be more detailed and containing written authorization to obtain credit background information. 
I/We recognize that this application is subject to acceptance or rejection. I/We hereby state that the information set forth above is true and complete and authorize verification of the information and references given. 
By submitting below, I/we attest to the fact that we have read and accept this application, and that all of the statements included in this application are true and correct.