OAK MOUNTAIN PROPERTIES, INC.
RENTAL APPLICATION
20 Baltic Place, Suite 1 Croton on Hudson, NY 10520 Phone: (914) 271-3666 Fax: (914) 271-4743 Email:
[email protected] Web: amberlandsapartment.com
Date____________________________ Apt No______________Rent________ Approval_________________________
Date of Application______________________________________________
Desired Move in Date_________________________________________
Size of Apartment (No. of Bedrooms, etc.)____________________________
No. of Cats (sorry no dogs allowed)______________________________
PERSONAL INFORMATION APPLICANTS FULL NAME__________________________________________ SSN___________________________ HOME PHONE________________________
DATE OF BIRTH______________________________________________
DRIVER’S LIC. NO./STATE__________________________
EMAIL____________________________________
WORK PHONE__________________________
CELL PHONE_______________________________
CO-APPLICANT’S FULL NAME_______________________________________ SSN_____________________________ HOME PHONE________________________
DATE OF BIRTH_______________________________________________
DRIVER’S LIC. NO./STATE__________________________
RELATIONSHIP______________________________
WORK PHONE__________________________
CELL PHONE________________________________
FULL NAMES OF ALL OTHER RESIDENTS
RELATIONSHIP TO YOU
DATE OF BIRTH
RESIDENCE HISTORY PRESENT ADDRESS________________________________________________________________________________________________________ Present Phone No.____________________________________
Dates From________________________________
Landlord or Mortgage Co.________________________________________________________ Monthly Payment $__________________________________________
Phone No._____________________________________
Reason for Moving________________________________________________
PREVIOUS ADDRESS___________________________________________________________________ Previous Landlord_______________________________________________________________________ Monthly Payment$___________________________________________
To_________________________
Dates From____________to______________ Phone No._____________________________
Reason for Moving_________________________________________________
EMPLOYMENT INFORMATION PRESENT EMPLOYER___________________________________________________________________
Dates From____________to______________
Employer’s Address______________________________________________________________________
Phone No._____________________________
Position_____________________________________ Supervisor_________________________________
Gross Monthly Salary____________________
PREVIOUS EMPLOYER___________________________________________________________________
Dates From____________to_______________
Employer’s Address_______________________________________________________________________
Phone No.______________________________
Position_____________________________________ Supervisor__________________________________
CO-APPLICANT’S EMPLOYER______________________________________________________________________
Dates From_____________to_______________
Employer’s Address________________________________________________________________________
Phone No._______________________________
Position_____________________________________ Supervisor__________________________________
Gross Monthly Salary_____________________
Page 1 of 5
BANKING AND CREDIT REFERENCES BANK NAME & BRANCH_____________________________________________________________________________
Phone No._______________________________
Checking Acct. No.___________________________________________
Savings Acct. No.____________________________________________________
Loan Acct. No._______________________________________________
Monthly Payment $__________________________________________________
CREDIT REFERENCE_____________________________________________________________________
Phone No._______________________________
Address________________________________________________________________________________
Account No._____________________________
CREDIT REFERENCE_____________________________________________________________________
Phone No._______________________________
Address________________________________________________________________________________
Account No._____________________________
OTHER REFERENCE_____________________________________________________________________
Phone No._______________________________
Address______________________________________________________________________________________________________________________ _____
OTHER INFORMATION TOTAL NUMBER OF VEHICLES (commercial vehicles not allowed)__________________________________________________________________________________ Make/Model_________________________________________
Year______________________ Color________________ Tag No./State________________________
Make/Model_________________________________________
Year______________________ Color________________ Tag No./State________________________
Other Car, Motorcycle, etc.____________________________________________________________________________________________________________________ If there are other sources in income you would like us to consider, please list income, sources and person (Banker, Employer, etc.) who we could contact for confirmation. You do NOT have to reveal alimony, child support or spouse’s annual income unless you want us to consider it in thi s application. Amount $____________________________ Per_______________________ Source____________________________ Phone No._________________________________ Amount $____________________________ Per_______________________ Source____________________________ Phone No._________________________________ Comments: ________________________________________________________________________________________________________________________________ HAVE YOU OR CO-APPLICANT EVER:
Been sued for non-payment of rent?
________Yes
Been evicted or asked to move out? Been sued for damage to rental property
________Yes ________Yes
Broken a Rental Agreement or Lease? ________Yes Declared Bankruptcy: _______Yes ________No
_________No _________No
In Case of Personal Emergency, Notify_______________________________________________________
________No _________No
Relationship______________________________________
Address________________________________________________________ Home Phone_________________________ Work Phone____________________ PLEASE NOTE, THERE IS A NON-REFUNDABLE APPLICATION FEE OF $75 FOR ONE PERSON AND $100 FOR TWO PEOPLE. I hereby make this application for an apartment and certify that this Information is correct. I authorize you to contact any references that I have
APPLICANT’S SIGNATURE_____________________________________________
listed. I also authorize OAK MOUNTAIN PROPERTIES, INC. to obtain by consumer credit report from a credit reporting agency, which will appear as an inquiry on
CO-APPLICANT’S SIGNATURE__________________________________________
my file.
DATE SIGNED________________________________________________ FOR OFFICE USE ONLY – DO NOT WRITE BELOW
Date Application Received___________________________________________ REFERENCE VERIFICATION
Received By_____________________________________________________________
REMARKS
Present Landlord Previous Landlord Employment Previous Employment Co-Applicant Employment Bank Credit (1) Credit (2) Other Application Fee Received__________________________Application Approved_________________________ Move in Date_________________Apt. No______________ Page 2 of 5
Oak Mountain Properties, Inc. 20 Baltic Place Suite 1 Croton on Hudson, NY 10520 Phone: (914) 271-3666 Fax: (914) 271-4743 Rental Application VERIFICATION OF EMPLOYMENT INCOME Name and Address of Employer: ______________________________________________________________________ ________________________________________________________________________________________________ Re: _____________________________________________ Applicant/Tenant
Social Security #: ___________________________
__________________________________________________________________________________________________________ Applicant/Tenant Address City, State Zip Code The individual named above is an applicant for, a unit that requires verification of family income and other information related to eligibility. We would appreciate your prompt response. If you have any questions, please feel free to contact our office. Thank you for your cooperation. AUTHORIZATION: I authorize the release of the information requested on this verification form. ______________________ Date
______________________________________________ Signature (Applicant/Tenant)
************************************************************************************************************ TO BE COMPLETED BY EMPLOYER: 1. Date of hire: _________/_________/_________ Position____________________________________________ 2.
If salaried employee, $________________________ per ______________________(week, month, year, etc.) Average regular hours worked weekly: ___________ Hourly Rate:$___________________ Average overtime hours worked weekly: ___________ Overtime rate:$_________________
3.
Average total weeks compensated per year: _____________________
4.
Does the employee earn: Tips? Additional compensation? ______Yes ______No Commissions or bonuses? ______Yes ______No
5.
6.
If yes, amount: $__________________ If yes, amount: $__________________
Do you anticipate an increase in base pay over the next 12 months? _________Yes __________No If yes, amount: $_______________per_______________. Effective as of:________________________ Total Gross Earnings Anticipated for the next twelve months: $________________________ (Including all tips, bonuses, overtime, commissions, anticipated changes)
I certify that the above information is true and correct. ______________________________________ Name/Title of Company Official
_____________________________________ Signature
______________________________________ Date
_____________________________________ Telephone Number Page 3 of 5
Oak Mountain Properties, Inc. 20 Baltic Place Suite 1 Croton on Hudson, NY 10520 Phone: (914) 271-3666 Fax: (914) 271-4743 Rental Application VERIFICATION OF EMPLOYMENT INCOME Name and Address of Employer: ______________________________________________________________________ ________________________________________________________________________________________________ Re: _____________________________________________ Applicant/Tenant
Social Security #: ___________________________
__________________________________________________________________________________________________________ Applicant/Tenant Address City, State Zip Code The individual named above is an applicant for, a unit that requires verification of family income and other information related to eligibility. We would appreciate your prompt response. If you have any questions, please feel free to contact our office. Thank you for your cooperation. AUTHORIZATION: I authorize the release of the information requested on this verification form. ______________________ Date
______________________________________________ Signature (Applicant/Tenant)
************************************************************************************************************ TO BE COMPLETED BY EMPLOYER: 1. Date of hire: _________/_________/_________ Position____________________________________________ 2.
If salaried employee, $________________________ per ______________________(week, month, year, etc.) Average regular hours worked weekly: ___________ Hourly Rate:$___________________ Average overtime hours worked weekly: ___________ Overtime rate:$_________________
3.
Average total weeks compensated per year: _____________________
4.
Does the employee earn: Tips? Additional compensation? ______Yes ______No Commissions or bonuses? ______Yes ______No
5.
6.
If yes, amount: $__________________ If yes, amount: $__________________
Do you anticipate an increase in base pay over the next 12 months? _________Yes __________No If yes, amount: $_______________per_______________. Effective as of:________________________ Total Gross Earnings Anticipated for the next twelve months: $________________________ (Including all tips, bonuses, overtime, commissions, anticipated changes)
I certify that the above information is true and correct. ______________________________________ Name/Title of Company Official
_____________________________________ Signature
______________________________________ Date
_____________________________________ Telephone Number Page 4 of 5
Oak Mountain Properties, Inc. 20 Baltic Place, Suite 1 * Croton-On-Hudson, NY 10520 Phone: (914) 271-3666 *Fax: (914) 271-4743 * E-Mail:
[email protected] To: From: Fax #/Address Date: Tenant: Address:
__________________________________________________________________ __________________________________________________________________
The above named individual(s) has/have applied for an apartment at Oak Mountain Properties, Inc. and has given your name as present/former landlord. In order to verify the information reported to us, please complete this form and fax back to me at (914) 271-4743. What time period has the above named applicant(s) rented from you? ________________________________
How many tenants are on the Lease or living under the present rental agreement with the applicant(s)? ________________________________________________________________
Does the applicant(s) have a pet? _______________
If yes, what type? _______________
Monthly Rent Amount $___________________
Always paid on time? _______________
Did, or will, full security deposit be returned? _________ If not, why? ________________________________________________________________________
Was tenant evicted? _________ If yes, why? ___________________________________________________
Payment Record (circle one)
Excellent
Good
Fair
Poor
Housekeeping Habits (circle one)
Excellent
Good
Fair
Poor
Form completed by: ___________________________________ Please Print Name ___________________________________ Signature
____________________ Date ____________________ Title
I/We consent to allow Oak Mountain Properties, Inc., through its agent and employees, to obtain and verify my/our information, criminal history, employment, income, and landlord references, for any purpose, including determining whether or not to lease me/us an apartment. I understand that should I/we lease an apartment, Oak Mountain Properties, Inc. shall have a continuing right to review these items. In addition to my/our residency application, payment history and occupancy history for account review purposes and for improving application methods. Oak Mountain Properties, Inc. may obtain information from any source and may exchange credit information with consumer reporting agencies. I/we also affirm that all the information in this application is true and complete. I/we make this representation knowing that if any such information proves false, Oak Mountain Properties, Inc. may cancel and annul any lease given in reliance upon such information. ___________________________________ ____________________ Signature Date ___________________________________ Signature Page 5 of 5
____________________ Date
