Hampton Village Rental Application

Please complete all requested information on this form. Thank you for your interest in our apartments.

Date of Application

 		 Desired Date of Occupancy
Type and size of Apartment Wanted (No. of Bedrooms, etc.)  
PERSONAL INFORMATION
APPLICANT'S FULL NAME
 		 Date of Birth
mm/dd/yy 		 
Social Security No.
 		 Driver's License No./State
 
CO-APPLICANT'S FULL NAME
 		 Date of Birth
mm/dd/yy
Social Security No.
 Driver's License No./State
 Relationship
 
Full Names of All Other Residents:
 Relationship to You
 Date of Birth
mm/dd/yy
How many Pets Do You or Other Occupants Own?    
Kind of Pet, Breed, Weight and Age   
How Did You Hear About Our Property? 
 
RESIDENCE INFORMATION
PRESENT ADDRESS
Present Telephone
Dates From:
mm/dd/yy		 To:
mm/dd/yy		  
Present Landlord or Mortgage Co.
 		 Telephone
 
Monthly Payment $
Reason for Moving
PREVIOUS ADDRESS
Dates From:
mm/dd/yy		 To:
mm/dd/yy
Previous Landlord or Mortgage Co.
 		 Telephone
 
Monthly Payment $
Reason for Moving
 
EMPLOYMENT INFORMATION
PRESENT EMPLOYER
 		Dates From:
mm/dd/yy		 To:
mm/dd/yy
Employer's Address
 		 Telephone
 
Position
 Supervisor
 Gross Monthly Salary $
PREVIOUS EMPLOYER
   
Employer's Address
 		 Telephone
 
Position
Supervisor
CO-APPLICANT'S EMPLOYER
Employer's Address
 		 Telephone
 
Position
 Supervisor
 Gross Monthly Salary $
BANKING AND CREDIT REFERENCES
BANK NAME & BRANCH
Telephone
*Checking Acct. No.
 		 *Savings Acct. No.  
*Loan Acct. No.
 		 *Monthly Payment $  
CREDIT REFERENCE
  		 Telephone
Address
 		 *Account No.  
CREDIT REFERENCE
  		 Telephone
Address
 		 *Account No.  
OTHER REFERENCE
Address
 		    
*Account information is optional. Leave this section blank and we contact you for additional information.
OTHER INFORMATION
TOTAL NUMBER OF VEHICLES (Including Company Vehicles)
Make/Model
 Year
Color
Tag No./State
Make/Model
 Year
Color
Tag No./State
Other Car, Motorcycle, etc.   
Total Gross Monthly Household Income $   
If there are other sources of income you would like us to consider, please list income, source and person (Banker, Employer, etc.) who we could contact for confirmation. You do NOT have to reveal alimony, child support or spouse's annual income unless you want us to consider it in this application.
Amount $
Per
 Source
 Telephone
Amount $
Per
 Source
 Telephone
Comments:  
HAVE YOU OR CO-APPLICANT EVER: Been sued for non-payment of rent? Yes No
Been evicted or asked to move out? Yes No
Broken a Rental Agreement or Lease? Yes No
Been sued for damage to rental property? Yes No
Declared Bankruptcy? Yes No
In Case of Emergency, Notify:
Relationship
 

Address

Home Phone
 Work Phone
I hereby make application for an apartment and certify that this information is correct. I authorize you to contact any references that I have listed. I also authorize you to obtain my consumer credit report from your credit-reporting agency, which will appear as an inquiry on my file. APPLICANT Yes No
CO-APPLICANT Yes No
DATE SIGNED mm/dd/yy