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ONLINE APPLICATION

Date: / /
Date Occupancy Desired:
/ /
Type of Apartment Desired:
Preference:
Price Range:

Additional Comments:

 *Applicant Contact Number:
*Applicant Email Address:

APARTMENT OCCUPANTS: (List all persons to occupy apartment)
Name
Date of Birth
Gender
Marital Status
Social Security No.
*

IN CASE OF EMERGENCY - NOTIFY: (Nearest relative not living with you)
Name
Address
City/State/Zip
Day Phone
Evening Phone
 Relationship

EMPLOYMENT
Company Name
Address
Business Phone
How long?
Position
 Monthly Gross$ Monthly Net$
Current:
Former:
Spouse Current:
Spouse Former:

Other Income for:
Source:
 Monthly Gross$:
 Monthly Net$:
Other Income for:
Source:
 Monthly Gross$:
 Monthly Net$:

RESIDENCE HISTORY
Present Address
Full address with city, state, zip code
Apt/Landlord/
Mortgage/Name
Landlord Phone Number
How Long?
Monthly Paymts.
 Reason for Moving
Former Address
Full address with city, state, zip code
Apt/Landlord/
Mortgage/Name
Landlord Phone Number
How Long?
Monthly Paymts.
 Reason for Moving

BUSINESS REFERENCES - BANK(S)
Name:
Address:
 City/State/Zip:
Type of account: Check No.:
Savings No.:
 Name of Account:
Name:
Address:
 City/State/Zip:
Type of account: Check No.:
Savings No.:
 Name of Account:

CREDIT REFERENCES (List all open credit & loan accounts. Show what loan covers: auto, motorcycle, boat, house, etc.)
Monthly Pymts. $
Balance Owed $
Paid To
Account #
For

AUTO(S) - MOTORCYLCE - BOAT - BICYCLE - PET
Driver's License No.
State
Auto (Year, Make, Model, Owner)

Is auto in good condition? Yes No
Color, License Plate, State
Spouse Driver's License No.
State
Auto (Year, Make, Model, Owner)

Is auto in good condition? Yes No
Color, License Plate, State
Motorcycle: Yes No
Licence Plate:
Boat: Yes No
Licence Plate:
Bicycle:
Yes No
Pet
Type:
Weight:
Name:

INSURANCE
Total Monthly Auto Insurance Payment(s)
Do you have Renter's Insurance?
Yes No
What is the Monthly Payment?

GENERAL
Have you or your spouse ever been sued? Yes No
If yes, please explain.
Have you or your spouse ever filed bankruptcy? Yes No
If yes, when?
Have you or your spouse ever been convicted of a felony? Yes No
If yes, please explain.
Do you own furniture to be moved into apartment? Yes No

Acceptance of this application, and any monies deposited, is not binding upon Landlord until approved by Landlord. At the time of application an amount of $300.00 will be taken as a Security Deposit. If applicant withdraws this application, a fee of $30.00 will be retained by Landlord as a fee for processing the application and as liquidated damage for the rental the Landlord has lost. It is further understood and agreed, if an apartment is held for applicant for more than 3 days all monies deposited shall be forfeited to Landlord. If this application is not approved by Landlord, the Security Deposit will be refunded. Applicant(s) further irrevocably authorize(s) Berkshire Management Company to transfer to the Owner-Landlord at any time, without liability to anyone, any and all deposits herein mentioned or otherwise required in connection with the occupancy of the applicant(s).

Applicant(s) hereby acknowledge(s) that the Owner-Landlord, or Berkshire Management Company, Agent of Owner, any affiliate, agent, or employee thereof, may procure an investigative consumer report concerning the applicant(s), including information as to the character, general reputation, personal characteristics, criminal background check, and mode of living of the applicant(s) and that the applicant(s) that have the right within a reasonable period of time hereafter to request a complete and accurate disclosure of the nature and scope of the investigation requested. Applicant(s) hereby expressly authorize(s) the Owner-Landlord, and Berkshire Management Company, Agent for Owner and their respective affiliates, agents, and employees to disclose to others any information about the applicant(s) possessed by them to the extend such disclosure is otherwise prohibited by law.

By signing below, you hereby ensure that all information provided is correct.
Applicant's Signature (please type in full name)
Date
1. *
 *
2.
3.
4.

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