The Village Quarter Apartments : Rental Application

The Village Quarter Apartments	FAX - (812) 877-2506
	Phone - (812) 877-1795
Date Printed:

Fill out our Application to Rent. FAX to (812) 877-2506

If you can't see this text on the printed version, and you can't see the site navigation graphics at the top, you're probably OK to FAX it - If you do see it, please do not FAX this document.

Fill in only the fields you want. Anything left blank will need to be filled in by hand. None of the information you type is stored on our server. This is merely a tool for producing a neatly typed 'application to rent' from The Village Quarter. A signature is required before faxing. Call us if you have any questions.

Application to Rent

Date:

How did you hear about The Village Quarter?

Name:

Social Security Number:

Address:

Phone:

City:

State:

Zip:

Present Rent:

Landlord

Phone:

Spouse's Name:

Social Security Number:

Date Of Birth (Applicant)

(Spouse):

Employment Information

Employer:

Phone:

Address:

Position:

Income:

Spouse Employer:

Position:

Income:

How Long Employed?:

Spouse:

Previous Employer (if less than one year):

References

Name of Bank (City & State):

Personal 1.:

Phone:

Personal 2.:

Phone:

Emergency Contact:

Phone:

Nearest Relative:

Phone:

Other

Names of Residents to Occupy Apartment:

Renters Insurance Required:

Agent:

(Copy of Declaration Page Required)

Have you ever filed a petition for bankruptcy?:

If YES, What Year?:

Have you ever been evicted from any tenancy?:

The Applicant has submitted a $25.00 Application Fee for the expense of processing this application. If the application is approved, $15.00 of the fee will be applied to the first month's rent. Should the Applicant cancel after a 24 hour period, the Lessor/Owner shall be entitled to a cancellation fee of $100.00.

I/We have applied to lease the property known as _________________________, Terre Haute, IN 47803, for a term of ________________ beginning ________________ at a monthly rental rate of $_________________. I also hereby understand that all utilities including Electric, Water, Sewage, Phone, & Cable are the responsibility of the resident.

I/We the Applicant(s) hereby state that the information provided is true and correct and hereby authorize the Lessor to make any investigation of my personal history, employment, financial and credit records.

Signature:

Date:

Signature:

Date:

Authorized Agent:

Date:

Accepting on behalf of The Village Quarter

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