The Pines Apartment Homes at Glen Pointe

Our Online Rental Application

APPLICANT INFORMATION
APPLICANT NAME	DATE OF BIRTH	DRIVERS LIC #	STATE	SOCIAL SECURITY #

HOME TELEPHONE	WORK TELEPHONE	EMERGENCY CONTACT	RELATIONSHIP	TELEPHONE

OTHER OCCUPANTS Note: Each adult occupant must complete separate applications.
FULL LEGAL NAME	RELATIONSHIP	DOB	SOCIAL SECURITY NUMBER




Do you have any pets? Description: Height/Weight:

PRESENT EMPLOYER
COMPANY NAME	ADDRESS, CITY, STATE, ZIP		PHONE

SUPERVISOR'S NAME	JOB DESCRIPTION	MONTHLY INCOME	EMPLOYMENT DATES

SPOUSE/PRESENT EMPLOYER
COMPANY NAME	ADDRESS, CITY, STATE, ZIP		PHONE

SUPERVISOR'S NAME	JOB DESCRIPTION	MONTHLY INCOME	EMPLOYMENT DATES

BANKING INFORMATION
BANK / CREDIT UNION NAME	BRANCH	PHONE NUMBER	SAVING/CHECKING	ACCOUNT NUMBER

CREDIT REFERENCES
NAME/TYPE OF ACCOUNT	ADDRESS	PHONE NUMBER	MONTHLY PMT.	BALANCE

AUTOMOBILES
MAKE	MODEL	YEAR	LICENSE PLATE NUMBER

Please check YES or NO.
1. Have you ever been evicted or refused to pay rent for any reason?

By submitting this application, I represent the above statements are true and complete and authorize verification of information and references given. A $30 non-refundable application fee per adult is charged to process the rental application. It is understood the security deposit received will be returned if applicant is not accepted as a resident. If accepted and the resident does not move in on the starting date given, the amount received is hereby acknowledged as liquidated damages for non-performance and will be forfeited by the resident as compensation for holding the apartment off the market.

I understand I may cancel this application by written notice within 72 hours and receive a full refund of security deposit. If I cancel after 72 hours, I understand I forfeit the deposit.

Do you agree to sign this application. Yes

Your Email:

RESIDENCE HISTORY

STREET ADDRESS

LAND LORD
NAME & PHONE