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Online Application
(Application will be forwarded to Landlord for screening)
*
Indicates required field
Unit Applying For
*
ex. 1127 Saint Paul #8
Rent
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Desired Move In Date
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Name of Applicant
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First
Last
Social Security #
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Middle
*
Email
*
Phone Number
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Date of Birth
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MM/DD/YYYY
Current Address
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Line 1
Line 2
City
State
Zip Code
Country
Time at Current Address
*
ex. 1 year
Name of Current Landlord
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First
Last
Phone Number of Current Landlord
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Email of Current Landlord
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Current Occupation
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Time at Current Occupation
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ex. 1 year
Monthly Salary
*
Name of Current Employer
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First
Last
Phone Number of Employer
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Will anyone else be moving in with you? (if yes, specify below)
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Yes
No
Maybe
Specify
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Do you have a pet?(if yes, specify below)
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Yes
No
Specify
*
Convicted of Criminal Offense (if yes, specify below)
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Yes
No
Specify
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Litigations (if applicable, specify below)
*
None
Suits
Judgements
Bankruptcies
Foreclosures
Evictions
Specify
*
Co-Applicant
Name
*
First
Last
Date of Birth
*
MM/DD/YYYY
Phone Number
*
Email
*
Social Security #
*
Current Occupation
*
Monthly Salary
*
PLEASE READ ALL TERMS BELOW:
I hereby authorize VacancyFillers.com LLC to forward this application to Landlord and for Landlord to obtain information it deems desirable in the processing of my application, including; credit reports, civil or criminal actions, rental history, employment/salary details, police and vehicle records, and any other relevant information; and releases VacancyFillers.com LLC,
its employees and agents
and Landlord,from all liability for any damage whatsoever incurred in furnishing or obtaining such information. Upon approval and acceptance, the applicant agrees to execute a lease before possession is given and to pay the security deposit and the first month’s rent within five days after being notified of acceptance(time being of the essence); failing which the application fee shall be retained by the Landlord as the agreed compensation for credit investigation, processing and verification of the application, other expenses and/or loss of rent, and the Landlord shall have no further obligation to applicant. In no event is the application fee refundable to the applicant, except in the event that Landlord fails to deliver possession of the premises as may be required by any lease executed between parties. The applicant hereby waives any claim for damages by reason of non-acceptance of this application which the Landlord or its agent may reject without stating reasons for so doing. It is further agreed that if any information herein is false, the lease made on the strength of this application may, at the option of the Landlord, be terminated at any time.
I accept the terms stated above
*
Accept
Submit