Apartment Applying for:______________________________Apt#______Move In:____/____/____

Applicant's Name:___________________________________SS# ___ ___ ___- __ __ - ___ ___ ___

Co-Applicant's Name:________________________________SS# ___ ___ ___- __ __ - ___ ___ ___

Phone # (___)____________________ (Optional) DOB Appl:_____/____/____ Co-Appl ____/____/____

Dr. Lic Appl.______________________State______ Co-Appl __________________-____State______

CurrentAddress___________________________City____________________St_______Zip___________

(If current address is less than 3 years)
PreviousAddress__________________________City____________________St_______Zip_________

Previous Landlord Information (Not Current Landlord):

Property Name or Property Management Co._____________________________________________

Landlord or Contact Name______________________________Phone # (___)_________________

Landlord Address__________________________City_________________St______Zip_________

Monthly Rental Amount_______________ Resided on premises From __________To __________

Employment Information:

Employer/Company Name_________________________________________________________

Address__________________________City_______________________St_______Zip________

Supervisor's Name __________________________________ Phone # (___) _________________

Position______________________Salary $_________ Start Date/Length of Employment_________

Co-Applicant:
Employer/Company Name_________________________________________________________

Address__________________________City_______________________St_______Zip________

Supervisor's Name __________________________________ Phone # (___) _________________

Position______________________Salary $_________ Start Date/Length of Employment_________

I/We confirm that all the information supplied is true and correct. I/we understand that I/we can be turned down for the apartment if I/we have falsified any information on this application. I/we hereby authorize the verification of all above information by American DataBank, including my credit, rental, check writing and employment history including salary.

Applicant's Signature ____________________________________ DATE ___________

Co-Applicant's Signature__________________________________DATE___________

FOR OFFICE USE ONLY: CALL AMERICAN DATABANK 1-800-200-0853 OR FAX TO 1-800-717-5787 TO PROCESS THIS APPLICATION. THE COMPLETED APPLICATION SHOULD BE KEPT ON FILE FOR 2 YEARS REGARDLESS OF ACCEPTANCE OR DENIAL.