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    Address:

    Unit #:

    *

    Monthly Rent:

    $*

    Date Applied:

    *

    Move-in Date:

    *

    Number of Occupants:

    *

    IMPORTANT: Please check ALL items below

    I understand my application fee is non-refundable.*

    I understand that if after making my application or being accepted, if I do not take occupancy of the apartment, I forfeit my security deposit.*

    I understand my move-in date, if approved by the owner, is final and I will be responsible for rent beginning on that chosen date.*

    I understand that the apartment will be rented as is.*

    I understand and agree possession of apartment will not be prior to the agreed upon move-in date listed above without exception to my lease.*

    I understand the information presented to me on the apartment I'm applying for is deemed accurate and reliable but not guaranteed or warranted by Sagal Realty Group, LLC or its Authorized Agents.*

    Application for Rent

    Applicant Data

    Name:

    *

    Date of Birth:

    *

    SSN:

    *

    Home Phone:

    *

    Cell Phone:

    E-mail:

    *

    Drivers License # & State:

    *

    Residence History

    Current Address:

    Apartment #:

    City:

    State:

    Zip Code:

    Monthly Rent/Mortgage:

    Community Name/Landlord/Mortgage Holder:

    Phone Number:

    Occupancy Dates:

    Employment Information

    Current Employer:

    Address:

    Phone Number:

    Position:

    Supervisor's Name:

    Length of Employment:

    Gross Monthly Income:

    Other Monthly Income:

    Emergency Contacts

    Name:

    Address:

    Phone Number:

    Relationship:

    Name:

    Address:

    Phone Number:

    Relationship:

    Has Applicant Listed Herein Ever:

    (If any of the answers below are "yes", please explain)
    Been Convicted of and/or pled "guilty" or "no contest" to any felony charges? YesNo

    Been evicted from a rental dwelling, or received a notice to vacate? YesNo

    Have you ever broken a rental agreement? YesNo

    Have you ever declared bankruptcy? YesNo

    Security

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