Application

"*" indicates required fields

RESIDENT BASIC INFORMATION

Applicant Name:*

First Middle Last

Phone:*

Social Security Number:*

Date of Birth:*

MM slash DD slash YYYY

Email:*

RESIDENT RENTAL HISTORY

Present Address:*

Street Address Address Line 2 City State ZIP Code

Move in date:*

MM slash DD slash YYYY

Move out date:*

MM slash DD slash YYYY

Monthly Payment:*

Reason for moving:*

GUARANTOR BASIC INFORMATION

(REQUIRED FOR ALL IF DIFFERENT THAN ABOVE)

Guarantor Name:

First Middle Last

Guarantor Phone:

Social Security Number:

Date of Birth:

MM slash DD slash YYYY

Guarantor Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Years at current address:

Guarantor Email:

RESIDENT EMPLOYMENT INFORMATION

Proof of income REQUIRED – Paycheck stub, employment offer letter, or tax return.

Current Place of Employment:*

Date started:*

MM slash DD slash YYYY

Monthly income:*

EMERGENCY CONTACT

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Relationship:*

Please answer the following questions:

Have you ever been evicted from any apartment in the last five (5) years?*

Yes

(If yes, please explain below)

Please explain here...

Have you ever filed bankruptcy?*

Yes

Chapter filed:

Date:

MM slash DD slash YYYY

Have you ever been sued for non-payment or a debt?*

Yes

(If yes, please explain below)

Please explain here...

Have you ever been served an eviction notice or asked to vacate a property you were renting?*

Yes

(If yes, please explain below)

Please explain here...

Have you ever refused to pay rent when due?

Yes

(If yes, please explain below)

Please explain here...

Have you ever broken, or in any manner failed to honor a lease or rental agreement?

Yes

(If yes, please explain below)

Please explain here...

RENTAL AGREEMENT

You (“Applicant(s)”) are submitting an application to live at Hayden Village Townhomes located at 280 East Washington. By submitting payment to Brinkman Properties, LLC or its designated Agent (“Landlord”) as outlined below, you agree to the following:

Application Terms:*

I agree to the Application Terms.

The Applicant(s) understand the Application, Administration, and Reservation Fees are non-refundable payments. Such sums are not rental payments and do not guaranty rental rate. Applicant(s) understand that the Reservation Fee will be converted to a Security Deposit upon the execution of a Lease with the Landlord. A Lease must be signed within 24 hours of notification of lease generation. Base rental rates are only guaranteed for the applied for unit at the time of application and/or once a lease agreement is executed. If a Lease is not signed and returned within 24 hours of delivery to Applicant(s), Landlord reserves the right to rescind the Lease offer and/or cancel the application.

If the Applicant fails to provide the required documentation outlined in this Rental Application Agreement within 48-hours of the application date, the application will be voluntarily canceled by the Applicant, and the non-refundable Application, Administration and Reservation Fees will be retained by Landlord as liquidated damages.

Income/Employment- Applicant(s) must have a verifiable source of income that is equal to a minimum of 2 times the monthly base rent. Applicant(s) must provide proof of employment and income through a copy of a most recent pay stub, prior year’s tax return, or W-2. If other forms of proof of employment/income are submitted in lieu of pay stubs or W-2, those are subject to Landlord’s approval.

Notice of Resident Selection Criteria: Applicant(s) acknowledge that Landlord may obtain a background report about the Application and that such report may include information on Applicant(s)’ credit and criminal histories. Applicant(s) also acknowledge that the application may be rejected based on information contained in such reports. Applicant(s) release all parties from liability for any damage that result from furnishing such information to Landlord. By signing below, Applicant(s) further acknowledge that they have had the opportunity to review the Landlord’s Resident Selection Criteria which include:

(1) criminal history, (2) previous rental history, (3) current income, (4) credit history, (5) failure to provide accurate or complete information on the application form, and (6) any other legitimate non-discriminatory information that might be relevant to the resident selection process. If Applicant(s) do not meet the selection criteria, Applicant(s) acknowledge that the application may be rejected and, as provided below, the Non-Refundable Fees stated below, will not be refunded. Based on the results of the screening process, applications may be approved, conditionally approved, or denied. Applications that are conditionally approved may require payment of an additional deposit, and/or a Guarantor.

Failure of any individual Applicant or co-Applicant to be approved will result in all applicants being denied. The individual Applicant that doesn’t meet the requirements will receive the FRCA letter detailing the reasons for the result at the time of denial. Credit and Background Screenings are processed by RentGrow, Inc. dba Yardi Resident Screening. If Applicant takes exception with the credit findings, he or she is responsible for contacting the credit bureau and RentGrow Inc, located at 177 Huntington Ave, Suite 1703 #74213, Boston, MA 02155-3153, or by phone: (800) 898-1351.

Once an application has been approved, the Applicant(s) agree(s) to sign a lease within 24 hours of notification of Lease generation. Failure to sign a lease within 24 hours of notification of Lease generation could result in cancellation of the application without refund of the non-refundable fees stated above, and/or the Landlord may rescind the offer of Lease.

If the application is denied or if the Applicant withdraws the application in writing within 48 hours of the date of the signed application, the Administration and Reservation Fees will be refunded to the Applicant(s), provided the payment has been deposited in and verified by Landlord’s bank. A refund, in the form of a check, will be mailed to Applicant(s) within 7 business days from the date of denial or date of cancellation, and upon verification of payment.

I understand that all fees and deposits are due with submission of this application, and that the application will not be considered, nor will a unit be reserved from the market advertising, without these fees having been paid.

Non-refundable fee(s):

Application Fee: $50.00 per Applicant
Reservation Fee: $500.00* per Lease Contract

*This amount will be converted to a portion of the Security Deposit upon Lease signing by all Applicants, Guarantors (if applicable) and Landlord. An additional deposit maybe required upon screening.

Any faxed or electronically signed documents with signatures pertaining to the lease, will be accepted in good faith and shall be considered original signatures. I have read and understand all the information provided above, and I will seek legal counsel if I have any questions or concerns, PRIOR to signing this document or any other documents provided by Landlord or Agent.

PRIMARY APPLICANT SIGNATURE:*

ROOMMATE APPLICANT SIGNATURE:

CAPTCHA

Application

RESIDENT BASIC INFORMATION

RESIDENT RENTAL HISTORY

GUARANTOR BASIC INFORMATION

RESIDENT EMPLOYMENT INFORMATION

EMERGENCY CONTACT

Please answer the following questions:

RENTAL AGREEMENT

Short Term Rental

Long Term Rental

Floor Plan

Location