Shriver Rental Properties | Online Rental Application

Desired Unit

Fields marked with an asterisk (*) are required.

Location: * Unit #: *

Desired Move In Date: *

Personal Information

Fields marked with an asterisk (*) are required.

Full Legal Name: *

Current Address: *

Social Security #: - - *

Date of Birth: / / *

Home / Main Phone #: - - * Cell Phone #: - -

E-mail Address: *

Residence History

Fields marked with an asterisk (*) are required.

Current Address: *

Rent Per Month: Date of Residency: / / to / /

Landlord's Name: Landlord's Phone #: - - *

Reason for Leaving:

Previous Address:

Rent Per Month: Date of Residency: / / to / /

Landlord's Name: Landlord's Phone #: - -

Reason for Leaving:

In Case of Emergency

Fields marked with an asterisk (*) are required.

Full Name: * Relationship: *

Address *

Home / Main Phone #: - - * Work Phone #: - -

Important Information

This form can NOT be processed without this information!

1) Have you ever been evicted? Yes No Please Explain:

2) Have you ever been convicted or plead guilty for usage/possession of drugs or drug paraphernalia or manufacture or distribution of a controlled substance? Yes No

3) Have you ever been convicted or plead guilty to any crime other than minor traffic violations? Yes No

4) Are you an illegal abuser of any controlled substance? Yes No

5) Are you a registered sex offender? Yes No

If there is anything on your credit report or additional information regarding your rental history that you would like to share, please do so here:

Employment / Student Status

Fields marked with an asterisk (*) are required.

Student Status: Undergraduate Graduate Full-Time Part-Time

Major:

Employed By: Salary: $ per

Address:

Supervisor(s):

Business Phone #: - - Supervisor Phone #: - -

Other Pertinent Information

Fields marked with an asterisk (*) are required.

Do you have a: Automobile? Waterbed? Bicycle?

Motorcycle? Renters Ins.?

Reason for leasing at Shriver Rental Properties?

Additional comments (earlier move-in date, roommate, etc):

Additional Terms

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By checking this box, you (The Applicant) agree to these terms and hereby authorize Shriver Rental Properties to seek reference information from the above sources, verify the above information, and obtain a credit history on the applicant.

A copy of the Applicant's Photo ID along with a security deposit in the amount of $* will accompany this application (Directions) and is non-refundable if applicant is approved by Shriver Rental Properties, but fails to execute a lease. A $25 application fee will be deducted from this security deposit at the time of move-out or at the time the application is denied.

This information is true and accurate and if found otherwise lease will be terminated and/ or legal action may be taken.