RENTAL APPLICATION COVER SHEET

Rental Application Form – Please print out all responses on application. The rear of the application may be used for additional information if needed.

Incomplete Applications – will not be processed.

Application Fee (s) - $35.00 for the first two applicants and, $25.00 for each additional applicant to be in cash or money order. Fee includes cost for credit report and any or all written verifications of income, prior residence or other references.

Fee is non-refundable once the process to verify information has begun.

PLEASE INCLUDE WITH ALL APPLICATIONS, Photo Copies of:

1: Two recent Pay Stubs

2: Picture I.D.

3: Social Security Card

First Month’s Rent & Deposit – Are required to be in the form of cashiers check or money order.

Village Properties

FULL NAME__________________________________PHONE( )_____________________________

DATE OF BIRTH____________SOCIAL SECURITY #_______________DRIVERS LIC#____________

SPOUSE NAME_________________DATE OF BIRTH________________SOC. SEC#_______________

DRIVERS LIC#__________________PETS (NUMBER & KIND)________________________________

OTHER > RELATIONSHIP/NAMES_______________________________________________

OCCUPANTS > AGES _______________________________________________________________

VEHICLE (S) MODEL & YEAR__________________________________________________________

PLEASE GIVE US YOUR RESIDENCE HISTORY FOR THE PAST 3 YEARS. (CURRENT TO LAST)

CURRENT ADDRESS________________________CITY_________________ST._______ZIP________

DATE IN___________DATE OUT____________ RENTAL AMT.$___________REASON LEFT?_____

OWNER OR AGENT___________________________________PHONE ( )______________________

PREV. ADDRESS (IF WITH IN 3 YRS)_____________________________________________________

DATE IN__________DATE OUT___________RENTAL AMT$__________REASON LEFT?_________

OWNER OR AGENT___________________________________PHONE( )_______________________

IF NECESSARY PLEASE USE BACK FOR ADDITIONAL ADRESSES:

EMPLOYMENT INFORMATION

YOUR STATUS: ____EMP. FULL-TIME___PART-TIME____STUDENT____RETIRED____U/E

EMPLOYER________________________________________MO. GROSS INCOME________________

ADDRESS_________________________________________________PHONE( )__________________

DATE EMP FROM___________TO________POSITION HELD_________________________________

SUPERVISOR________________________________________PHONE( )_______________________

IF EMP. LESS THEN 2 YRS. USE BACKTO LIST PREV. EMP / SAME APPLIES TO SPOUSE

SPOUSE STATUS:____EMP. FULL-TIME____PART-TIME____STUDENT____RET____U/E

EMPLOYER_________________________________________MO. GROSS INCOME_______________

ADDRESS_______________________________________________PHONE( )____________________

DATE EMP. FROM______________TO____________POSITION HELD__________________________

SUPERVISOR_________________________________PHONE #( )______________________________

YOUR BANK (S)

1. ______________________________CITY-STATE________________TYPE OF ACCT____________

2. ______________________________CITY-STATE________________TYPE OF ACCT____________

EMERGENCY CONTACT__________________________________________PHONE( )____________

ADDRESS_________________________CITY__________________STATE___________ZIP_________

RELATIONSHIP_______________________________________________________________________

HAVE YOU EVER: FILED PETITION FOR BANKRUPTCY? ____NO ____YES

BEEN EVICTED FORM ANY TENANCY? ____NO ____YES

WILLFULLY & INTENIONALLY REFUSED

TO PAY ANY RENT WHEN DUE? ____NO ____YES

IF YES TO ANY QUESTIONS ABOVE, PLEASE EXPLAIN: ___________________________________

I DECLARE THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT, AUTHORIZE ITS

VERIFICATION AND THE OBTAINING OF A CREDIT REPORT. I UNDERSTAND THAT ANY

OMISSIONS OR FALSIFIED INFORMATION WILL RESULT IN THIS APPLICATION BEING

DENIED, OR IMMEDIATE EVICTION OF RESIDENCY.

SIGNATURE OF APPLICANT_______________________________________DATE________________

SIGNATURE OF APPLICANT_______________________________________DATE________________