Congrats, You’ve made it to Step #2

Please fill this out and you’ll be offered a Home Tour if we have a spot available. Text Mary at 740-277-1619 when you’re done with the form, and she will take great care of you!!

Rental and Work History Form

Name

First Name

Last Name

Address Applying for

Desired Move-In Date

SS#

Who else will be living with you now or in the future or part-time?

What are their ages? Please include all residents including minor children who may have visitation or stay periodically or other unrelated adults

Rental History

Please include all addresses you have lived at for the previous 5 years. Current Address

City, State, Zip

Move-in Date

YYYY

Landlord’s Name

Landlord's Phone

(###)

###

####

Monthly Rent

Reason for Moving

Previous Address #1

City, State, Zip

Move-in Date

YYYY

Move-out Date

YYYY

Landlord’s Name

Landlord’s Phone

(###)

###

####

Monthly Rent

Reason for Moving

Previous Address #2

City, State, Zip

Move-in Date

YYYY

Move-out Date

YYYY

Landlord’s Name

Landlord’s Phone

(###)

###

####

Monthly Rent

Reason for Moving

Employment Information

Please include all sources of income. Use additional paper if needed. Self-employed: Please supply tax returns for the previous two years. Every adult needs to submit 3 months pay stubs and 3 most recent bank statements ALL PDF PAGES FOR EACH (Screenshots are NOT acceptable). You can mail those to PO BOX 1218 Lancaster Ohio OR you can contact our office for a secure portal link to upload digital copies. Current Employer

Position

Employer Phone Number

(###)

###

####

Supervisor Name

Take Home (Net) Wages Per Month

Hire Date

YYYY

Other Sources of Income

Amount Per Month

Explain

Questionnaire

Please answer all these questions truthfully. How long would you like to live here?

How many felonies do you have?

How many vehicles do you own?

Is the total move-in amount available now?

Do you have a checking account?

Current Balance:

Do you have a savings account?

Current Balance:

Emergency Contact

Name

Phone

(###)

###

####

Relationship

*must be someone who is NOT in your household (Including to contact regarding rent or tenancy.)

Additional Information

Please use this optional space for additional information, comments, or explanations.

Signature

*Please read carefully and sign and date below if you agree. Applicant certifies that the information contained in this application is true and correct. Applicant understands that false or misleading information is grounds for immediate disqualification. Authorization Applicant authorizes the Landlord or Landlord’s representatives to make any inquiries deemed necessary to verify the Applicant is the most qualified based on the below-stated qualification standards. This verification includes, but is not limited to, direct contact with Applicant’s employers, current landlord, previous landlords, friends, personal and professional references, law enforcement agencies, government agencies, consumer reporting agencies, public records, eviction records, and any other sources of information which the Landlord or Landlord’s representative may deem necessary. Applicant verifies that the Landlord and Landlord’s representatives shall not be held liable for damages of any kind that result from the verification of the information provided. This authorization shall extend through Applicant’s tenancy to ensure continued compliance to the terms of the tenancy or to recover any financial obligations relating to Applicant’s tenancy and beyond the expiration of Applicant’s tenancy for recovery of any financial obligations, or for any other acceptable purpose. Qualification Standards Your Application may be denied if you do not meet the below standards for qualification. Applicant must have current photo identification and a valid social security number. Applicant's monthly household income must exceed three times the rent. All income must be from a verifiable source. Unverifiable income will not be considered. Applicants must receive positive references from all previous landlords for the previous 5 years. Applicant may not have any evictions or unpaid judgments from previous landlords. Applicant must exhibit a responsible financial life. Credit score must be a minimum of 600. A background check will be conducted on all applicants over 18. Applicant’s background must exhibit a pattern of responsibility. Applicant must be a non-smoker. Occupancy is limited to 2 people per bedroom. At landlord’s discretion, compensating factors such as an additional security deposit or co-signer (guarantor) may be required for qualification if the Applicant fails to meet any one of the above requirements. In the event of multiple applicants, the tenancy will be granted to the most qualified, based on the above criteria. Applicant authorizes the release of all information to the Landlord and agrees that the information provided in this rental application is true and correct. This authorization extends beyond the end of Applicant’s tenancy. Please type your name below as your signature.

Date

YYYY