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Lofts At State & Main
Rental Application

First Name

Last Name

Phone

Current Address

Date Of Birth

Social Security Number

Current/Last Employer/School

Monthy Income From All Sources

Driver's License Number

Position/Program of Study

Length Of Time At Current Employer

Rental History

Name Of Last/Current Landlord

Last/Current Landlord Phone:

Name Of Previous Landlord

Thanks for submitting!

Previous Landlord Phone:

Length Of Last/Current Lease

Length Of Previous Lease

Have you ever broken a lease, been evicted, or been sued by a landlord

Yes

Additional Information

Names/Ages Of Other Occupants On Application Ages 18 And Up

Names/Ages Of Other Occupants On Application Under 18

Other adult occupants subject to criminal history check prior to approval

Have you or anyone on this application ever been convicted of a criminal offense

Yes

Have you or anyone on this application ever declared bankruptcy

Yes

Conditions

Landlord may refuse to rent to Applicant if any of the information provided herein is found to be untrue, and may terminate Applicant’s tenancy if information provided herein is found to be untrue after renting to Applicant.

If Landlord finds satisfactory screening results and offers rental of premises to Applicant, possession of the unit shall not be provided to Applicant until, in Landlord’s sole discretion, the premises are ready for occupancy and a lease is signed.

Except as provided in the lease, the Landlord shall not be liable for damages in the event the premises are not ready for occupancy on the date prescribed in the lease, and Landlord shall not be liable for damages in any event where the premises cannot be occupied on the prescribed date because of causes beyond Landlord’s control.

I authorize the person to whom this application is made and any credit bureau or other investigative agency employed by such person to investigate any references herein listed or statements or other data obtained from me or from any other source pertaining to my credit, financial responsibility, rental history, and criminal background. I also authorize the person to whom this application is made (including their agents) to obtain a copy of my credit report to assist in evaluating my application and, thereafter, to obtain and use in attempting to collect unpaid rent, late fees, or other charges from me.

I CERTIFY THAT I AM 18 YEARS OF AGE OR OLDER AND THAT ALL OF THE INFORMATION I HAVE PROVIDED IN RESPONSE TO THE QUESTIONS CONTAINED IN THIS APPLICATION IS TRUE. I FURTHER CERTIFY THAT I HAVE READ THE CONDITIONS CONTAINED AT THE BOTTOM OF THE APPLICATION FORM, THAT I UNDERSTAND THEM, AND THAT I VOLUNTARILY SUBMIT THIS APPLICATION KNOWING THAT SUBMISSION DOES NOT CONSTITUE A LEASE.

I accept these conditions.

Applicant Signature