PO Box 21179

Chattanooga, TN 37424-0179

423 894 6884

                                                                                                       RENTAL APPLICATION

PLEASE PRINT CLEARLY

DATE:                                   UNIT __________    3204 REDDING RD 37415

X_________________|____________________|______________

 «Last Name»                                             «First Name»                                                                            Phone #_«

SS#                                          Drivers license_________     ST:__ Birth date:     /   

Make of Car_______________License____________________________YR.________

Spouse Name     _______________________SS #_____________        Birth date:  /   /

Drivers License__________   Make of Car_______ License_____________YR.        

 Present Address with zipX_____________________________________________

_«Address Line 1»              «Apt #»              «City»          «State»            «ZIP Code»_

LANDLORD____________________PHONE#_________________          __How Long

(please have your landlord call 423-894-6884 or fax 423 894 9343 your payment history.)

Previous address:________________________________________ZIP__________

Previous address:________________________________________ZIP__________

PRESENT EMPLOYMENT_________________________PHONE:_______________

Position_____________________________   Monthly Gross Income_______________

Supervisor_____________________________Starting Date______________________

(please have your  EMPLOYER call 423-894-6884 or fax 423 894 9343 TO VERIFY.)

Spouse EMPLOYMENT_________________________PHONE:_______________

Position_____________________________   Monthly Gross Income_______________

Supervisor_____________________________Starting Date______________________

(please have your  EMPLOYER call 423-894-6884 or fax 423 894 9343 TO VERIFY.)

If more put on back of application or separate sheet of paper.

Reference:Name:___________________________Phone#__________________

(Other than person living with you)

Address:_________________________________________________Zip__________

Reference:Name:___________________________Phone#_______________________

(Other than person living with you)

Address:_________________________________________________Zip__________

LIST Additional ADULTS AND CHILDREN WHO WILL LIVE WITH YOU.

Name___________________ age_________    Name__________________age______

Name___________________ age_________    Name__________________age______

Name___________________ age_________    Name__________________age______

Emergency Contact:

Name:__________________Relationship_____________Phone #_______________

Address________________City_______________   ____State_______Zip_________

   Acceptance hereby authorizes verification of any or all information set forth on this Application including release of information by any bank or savings and loan. Employer (present and former) and any lender. All such information hereon, and released as authorized above, will be kept confidential. Applicant represents that the information set forth on this application is true and complete. Material misrepresentation of this Application will constitute a default under the lease or rental agreement between the parties. Credit Check charge: Applicant had submitted sum of $20.00 which is nonrefundable payment for a Credit Check and processing charge. Receipt of which is acknowledged by management. Such sum is not payment or deposit amount. In the event this application is approved or disapproved, this sum will be retained by management to cover the cost of processing application as furnished by applicant. Thus application must be signed before is can be processed my management. GOOD FAITH DEPOSIT: I hereby deposit $__$200.00_________with Management as a good faith deposit in connection with this rental application. If my application is accepted I understand the deposit can be applied toward payment of my security deposit of $200.00 when I take possession of the apartment. If for any reason management decides to decline any application the management will refund the good faith deposit to me in full.

Applicant Signature_________________Date__/__/___Signature______________________

 Do you have a pet (ie: cat, dog, etc) __________