Circle Hill Apartments Lease Application
Size of apartment desired __________________
Applicant:
Name______________________ Date of Birth ___________S.S.# _______________
Current Address_______________________________________________________
(Street (City) (State) (ZIP)
Phone#________________________ Driver’s License#________________________
Email Address_________________________________________________________
Landlord Name ____________________Phone# ____________How Long?________
Current Rent$ ___________When Due? ______Lease Expiration Date____________
Reason For Moving ____________________________________________________
Previous Address _____________________________________________________
(Street) (City) (State) (Zip)
Landlord Name ____________________Phone# ____________How Long? _______
Current Employer _____________________________________________________
Employer's Address ____________________________________________________
Contact Person ______________________________ Phone ___________________
Position _______________________________ How Long? ____________________
Pay $___________ Hourly Weekly Monthly (circle one)
Previous Employer ____________________________________________________
Previous Employer's Address ____________________________________________
Contact Person ______________________________ Phone ___________________
Position _______________________________ How Long? ____________________
Pay $_______Per Hour/ Week/ Month (Circle One)
Additional Income $___________________ Explain ___________________________
(continued on next page)
Credit Information
Account Name Number Balance Due Min. Payment
____________________________________________________________________
____________________________________________________________________
Checking Acct. At _____________________________How Long_________________
Savings Acct. At ______________________________How Long_________________
Occupants:
How many people will occupy this apartment? Total______Adults _____Children_____
List all persons who will live in this apartment:
Name_______________________D.O.B______________S.S.#__________________
Name_______________________D.O.B______________S.S.#__________________
Name_______________________D.0.B______________S.S.#__________________
Name_______________________D.O.B______________S.S.#__________________
Do you have pets? Yes________ No_________ If yes, what type_________________
In Emergency notify _______________________Relationship___________________
Address__________________________________Phone______________________
Litigations such as Evictions, Suits, Judgments, Bankruptcies, Foreclosures?________
If yes, Explain_________________________________________________________
I was referred by (how you heard about us) _________________________________
The application fee is non-refundable for any reason.
Any hold deposit given is non-refundable unless your application is denied!
I CERTIFY THAT I HAVE READ THE ABOVE APPLICATION; THAT THE INFORMATION CONTAINED THEREIN IS TRUE AND
CORRECT. I UNDERSTAND THAT THIS APPLICATION SHALL BE INCORPORATED IN AND BECOME A PART OF THE LEASE OF
THE PREMISES SOUGHT AND IF INCORRECT OR UNTRUE, SHALL BE GROUNDS FOR CANCELLATION OF THE LEASE. I
AUTHORIZE THE DISCLOSURE OF ANY INFORMATION THAT MAY BE NEEDED TO VERIFY THE STATEMENTS I HAVE
PROVIDED IN THIS APPLICATION INCLUDING BUT NOT LIMITED TO HOUSING, CREDIT & EMPLOYMENT.
Applicant Signature ___________________________________Date______________
Size of apartment desired __________________
Applicant:
Name______________________ Date of Birth ___________S.S.# _______________
Current Address_______________________________________________________
(Street (City) (State) (ZIP)
Phone#________________________ Driver’s License#________________________
Email Address_________________________________________________________
Landlord Name ____________________Phone# ____________How Long?________
Current Rent$ ___________When Due? ______Lease Expiration Date____________
Reason For Moving ____________________________________________________
Previous Address _____________________________________________________
(Street) (City) (State) (Zip)
Landlord Name ____________________Phone# ____________How Long? _______
Current Employer _____________________________________________________
Employer's Address ____________________________________________________
Contact Person ______________________________ Phone ___________________
Position _______________________________ How Long? ____________________
Pay $___________ Hourly Weekly Monthly (circle one)
Previous Employer ____________________________________________________
Previous Employer's Address ____________________________________________
Contact Person ______________________________ Phone ___________________
Position _______________________________ How Long? ____________________
Pay $_______Per Hour/ Week/ Month (Circle One)
Additional Income $___________________ Explain ___________________________
(continued on next page)
Credit Information
Account Name Number Balance Due Min. Payment
____________________________________________________________________
____________________________________________________________________
Checking Acct. At _____________________________How Long_________________
Savings Acct. At ______________________________How Long_________________
Occupants:
How many people will occupy this apartment? Total______Adults _____Children_____
List all persons who will live in this apartment:
Name_______________________D.O.B______________S.S.#__________________
Name_______________________D.O.B______________S.S.#__________________
Name_______________________D.0.B______________S.S.#__________________
Name_______________________D.O.B______________S.S.#__________________
Do you have pets? Yes________ No_________ If yes, what type_________________
In Emergency notify _______________________Relationship___________________
Address__________________________________Phone______________________
Litigations such as Evictions, Suits, Judgments, Bankruptcies, Foreclosures?________
If yes, Explain_________________________________________________________
I was referred by (how you heard about us) _________________________________
The application fee is non-refundable for any reason.
Any hold deposit given is non-refundable unless your application is denied!
I CERTIFY THAT I HAVE READ THE ABOVE APPLICATION; THAT THE INFORMATION CONTAINED THEREIN IS TRUE AND
CORRECT. I UNDERSTAND THAT THIS APPLICATION SHALL BE INCORPORATED IN AND BECOME A PART OF THE LEASE OF
THE PREMISES SOUGHT AND IF INCORRECT OR UNTRUE, SHALL BE GROUNDS FOR CANCELLATION OF THE LEASE. I
AUTHORIZE THE DISCLOSURE OF ANY INFORMATION THAT MAY BE NEEDED TO VERIFY THE STATEMENTS I HAVE
PROVIDED IN THIS APPLICATION INCLUDING BUT NOT LIMITED TO HOUSING, CREDIT & EMPLOYMENT.
Applicant Signature ___________________________________Date______________
