Rental Application
Full Name:
This field is required.
Middle Name:
Maiden Name:
Social Security Number:
This field is required.
Date Of Birth (MM/DD/YYYY):
This field is required.Invalid format.
Driver's License Number:
This field is required.
Driver's License State:
This field is required.
Marital Status:
Co-Applicant:
Total Number of Occupants: This field is required.Invalid format.
Children: (1) Age:
Children: (2) Age:

RESIDENCE INFORMATION

Current Address:
This field is required.
State/Zip:
This field is required.
Phone:
This field is required.
Amount of Monthly Rent: $
This field is required.Invalid format.
Date Lease Expires (MM/DD/YYYY): Invalid format.
Length of Occupancy: This field is required.Invalid format.
Reason for Leaving:
This field is required.
Owner or Agent:
This field is required.
Owner or Agent Phone:
This field is required.
Previous Address:
This field is required.
State/Zip:
This field is required.
Phone:
This field is required.
Amount of Monthly Rent: $
This field is required.
Length of Occupancy:
This field is required.
Owner or Agent:
This field is required.
Phone
This field is required.

EMPLOYMENT INFORMATION

Current Employer:
This field is required.
Position:
This field is required.
Length of Employment: This field is required.
Employer Phone:
This field is required.
Employer Fax:
Salary: $ This field is required.Invalid format. per
Supervisor's Name:
This field is required.
Other Income: $
Source:

MISCELLANEOUS INFORMATION

Vehicle Make: This field is required
 Model: This field is required
Year: This field is required
State: This field is required
This field is required
Financed With:
Monthly Payment:
This field is required.Invalid format.
Closest Relative Not Living With You:

This field is required.
Relative Phone:
This field is required.
Relative Address:
This field is required.
City/State:
This field is required. State: This field is required
Relationship:
This field is required.
How Did You Hear About The Development?
This field is required.

CO-APPLICANT INFORMATION

Full Name:
Middle Name:
Maiden Name:
Social Security Number:
Date Of Birth (MM/DD/YYYY):
Driver's License Number:
Driver's License State:
Marital Status:

CO-APPLICANT RESIDENCE INFORMATION

Current Address:
State/Zip:
Phone:
Amount of Monthly Rent: $
Date Lease Expires (MM/DD/YYYY):
Length of Occupancy:
Reason for Leaving:
Owner or Agent:
Owner or Agent Phone:
Previous Address:
State/Zip:
Phone:
Amount of Monthly Rent: $
Length of Occupancy:
Owner or Agent:
Phone

CO-APPLICANT EMPLOYMENT INFORMATION

Current Employer:
Position:
Length of Employment:
Employer Phone:
Employer Fax:
Salary: $ per
Supervisor's Name:
Other Income: $
Source:

CO-APPLICANT MISCELLANEOUS INFORMATION

Vehicle Make: Model:
Year:
State:
Financed With:
Monthly Payment:
Closest Relative Not Living
With You:
Relationship to you:
Relative Phone:
Relative Address:
Relative City/State:
Relative Zip
How Did You Hear About The Development?

APPLICANT’S CONSENT

I HEREBY AUTHORIZE MANAGEMENT OR ITS AGENT TO INVESTIGATE MY PAST HISTORY FOR THE PURPOSE OF DETERMINING APPROVAL OF THIS APPLICATION FOR RESIDENCY. THIS CONSENT INCLUDES ANY HISTORY OF RESIDENCY, EMPLOYMENT, CREDIT AND ANY OTHER REFERENCES THE MANAGEMENT DEEMS NECESSARY.

I/WE HEREBY AFFIRM THAT THE ANSWERS TO THE FOREGOING QUESTIONS ARE TRUE AND CORRECT, AND I/WE HAVE NOT KNOWINGLY WITHHELD ANY FACT OR CIRCUMSTANCE, WHICH WOULD, IF DISCLOSED, AFFECT TO VERIFY ANY AND ALL INFORMATION CONTAINED IN THIS APPLICATION. I/WE RELEASE ALL CONCERNED FROM ANY LIABILITY IN CONNECTION WITH ANY INFORMATION THEY GIVE. I/WE HAVE ALSO BEEN ADVISED THAT I/WE HAVE THE RIGHT, UNDER SECTION 606 (B) OF THE FAIR CREDIT REPORTING ACT, TO MAKE A WRITTEN REQUEST, WITHIN A REASONABLE TIME, FOR A COMPLETE AND ACCURATE DISCLOSURE TO THE NATURE AND SCOPE OF ANY INVESTIGATION AND THE NAME AND ADDRESS OF THE CONSUMER REPORTING AGENCY USED, IF ANY.

THE APPLICATION ALSO UNDERSTANDS THAT THIS APPLICATION IS NOT A RENTAL CONTRACT. IT IS UNDERSTOOD BY THE APPLICANT THAT HE/SHE/THEY ARE ACCEPTED AS TENANTS ONLY AFTER: (A) PAYING THE $75.00 RESERVATION DEPOSIT; (B) PASSING OF ALL PROPERTY OWNER’S REQUIREMENTS (LANDLORD VERIFICATION, EMPLOYMENT VERIFICATION, CREDIT INVESTIGATION, ETC.); (C) SIGNING A LEASE AND HAVING LANDLORD SIGN ALSO; (D) PAYING A FULL FIRST RENTAL PAYMENT PLUS SECURITY DEPOSIT WHERE REQUIRED; (E) HAVING RECEIVED A KEY TO THE PREMISES.

APPLICATION(S) ACKNOWLEDGE(S) THAT FALSIFICATION OF THIS APPLICATION IS CAUSE FOR IMMEDIATE REJECTION OF SAID APPLICATION BY LANDLORD. APPLICANT(S) ACCEPT(S) ALL OF THE FOREGOING AND AFFIRMS THAT HE/SHE/THEY HAVE RECEIVED A COPY OF THIS APPLICATION.

CANCELLATION POLICY

TO RESERVE AN APARTMENT, THE APPLICATION MUST PAY A RESERVATION DEPOSIT OF $75.00 PER APARTMENT AND AN APPLICATION FEE OF $35.00 PER ADULT HOUSEHOLD MEMBER. SHOULD THE APPLICANT CANCEL HIS/HER APARTMENT RESERVATION WITHIN 48 HOURS OF THE DATE OF APPLICATION, THE RESERVATION DEPOSIT WILL BE FULLY REFUNDED. CANCELLATION RECEIVED AFTER THE 48 HOURS WAITING PERIOD ARE NOT ELIGIBLE FOR DEPOSIT REFUND. CANCELLATIONS SHOULD BE SUBMITTED IN WRITING. RESERVATION DEPOSITS ARE NON-REFUNDABLE.

“Habitat America, LLC, is pledged to the letter and spirit of the U.S. Policy for the achievement of equal housing opportunity throughout the Nation. We encourage and support an affirmative advertising and marketing program in which there are no barriers to obtaining housing because of race, color, religion, sex, handicap, familial status or national origin.”

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THANK YOU FOR RESIDING WITH US!
equal housing opportunity

 

Full Name of First Applicant:
This field is required.
Date (MM/DD/YYYY): This field is required.Invalid format.
Full Name of Co-Applicant:
Date (MM/DD/YYYY):
The above signed hereby makes application to lease the premises located at
103 Overlook Drive, Salisbury, MD 21804.