Rental Application

Application fee is $35.00 non-refundable

Applicant information
Name Name First Last
SSN
Date of Birth Date of Birth / MM / DD YYYY
Driver's License Number
Driver's License State
Mobile Phone Mobile Phone - ### - ### ####
Email
Primary residence information
Primary Phone Primary Phone - ### - ### ####
Primary Address Primary Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Employer information
Employer Phone Employer Phone - ### - ### ####
Employer Address Employer Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Current landlord information
Landlord Name Landlord Name First Last
Landlord Phone Landlord Phone - ### - ### ####
Landlord Address Landlord Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Roommates

List each roommate on a new line.
Guarantor information -- also considered your Emergency Contact

All lease payments must be guaranteed by parents/guardians. If Applicant is self-supporting and over 21, then an approved sufficient income statement will be required otherwise a Guarantor's statement must accompany lease agreement.
Contact's Name(s)
Contact's Email
Contact's Phone Contact's Phone - ### - ### ####
Contact's Fax
Contact's Address Contact's Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Authorization

I give V-Tech Housing at Roanoke Street Apartments authorization to acquire Credit, Housing, and Employment verifications.
Date Date / MM / DD YYYY
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Rental Application

Rental Application

Applicant information

Primary residence information

Employer information

Current landlord information

Guarantor information -- also considered your Emergency Contact

Authorization