HOUSE RENTAL APPLICATION

The undersigned hereby makes this application to:

Property Owner ►
City & State ►

to rent a _________________ bedroom house for a lease term of ________________________________________________ months,

commencing on _________________________________, 2________, at a monthly rental of $______________________________________________.
HOUSE OCCUPANTS:
APPLICANT:

Full Name: _______________________________________________________________________________________________________________

First Middle Last

Social Security Number: _________________________________________ Date of Birth: ________________________________________

CO-APPLICANT:

Full Name: _____________________________________________________________________________________________________________

First Middle Last

Social Security Number: Date of Birth: __________________________________

OTHER OCCUPANTS:

Name: _______________________________ DOB: ________________ SS#: ______________________ Relationship: ___________________

Name: _______________________________ DOB: ________________ SS#: ______________________ Relationship: ___________________

Name: _______________________________ DOB: ________________ SS#: ______________________ Relationship: ___________________

APPLICANT MARITAL STATUS: Single ________ Married ________ Separated _______ Divorced _______

CURRENT / PREVIOUS ADDRESSES:

Have you ever lived in an apartment community or house managed by Lindsey Management Co., Inc.? Yes______ No_______

If yes, which apartment or what house address? Apt. Name/House Address______________________________________

City_________________________ State____________ When? _________________

CURRENT ADDRESS:

Rent: $ How Long: ________________________

Street Address Apt. #

Landlord Name: ____________________________________________

City Zip Code (Required)

Landlord Phone: ____________________________________________

Phone Date Moved Out

_______________________________________________________________________________________________________________
Reason for Moving

Lindsey Management Company, Inc.-Homes Division HD-1101—07.14.11

PREVIOUS ADDRESS (if at current address for less than 2 Years):

Rent: $ How Long: __________________________________

Street Address Apt. #
___________________________________________________________
Landlord Name:
City Zip Code (Required)
___________________________________________________________
Landlord Phone:
Phone Date Moved Out
________________________________________________________________________________________________________________
Reason for Moving

IN CASE OF EMERGENCY NOTIFY:

________________________________________________ ____________________________________________________
Name Phone
________________________________________________ ____________________________________________________
Address Relationship

CURRENT EMPLOYMENT/INCOME:
___________________________________________________________________________________________________________________
Applicant's Employer Address How Long? Phone
___________________________________________________________________________________________________________________
Gross Monthly Salary Additional Monthly Income (if any) Source
___________________________________________________________________________________________________________________
Co-Applicant's Employer Address How Long? Phone
___________________________________________________________________________________________________
Gross Monthly Salary Additional Monthly Income (if any) Source

REFERENCES:
BANK(S):
Checking Account: ___________________________________________________________________________________________________
Bank Name Phone Address City/State/Zip
Savings Account: __________________________________________________________________________________________________
Bank Name Phone Address City/State/Zip

CREDIT:
_____________________________________________________________________________________________________________________
Name Phone Address City/State/Zip Type of Credit
_____________________________________________________________________________________________________________________
Name Phone Address City/State/Zip Type of Credit
PERSONAL:
____________________________________________________________________________________________________________________
Name Phone Address City/State/Zip Relationship
____________________________________________________________________________________________________________________
Name Phone Address City/State/Zip Relationship
VEHICLES:
Applicant Driver's License #: State: Expires:
Vehicle #1 Model: License #: State:

Applicant Driver's License #: State: Expires:

Vehicle #2 Model: License #: State:

Lindsey Management Company, Inc.-Homes Division HD-1101—07.14.11

CREDIT/CRIMINAL: I hereby consent to allow Property Owner and/or its designated agents and employees, to obtain a consumer credit report and criminal
record information for the purpose of determining whether to lease a house to me. I also agree and understand that Owner and/or its agents and
employees may obtain additional consumer credit reports and criminal record reports on me in the future to update or review my account. Upon my
request, Owner and/or its agents or employees will tell me whether consumer credit reports or criminal record reports were requested and the names and
addresses of any consumer reporting agency that provided such reports.

INSURANCE: Neither the Owner nor its designated agents or representatives carry insurance on the personal property of residents or other occupants. It
is recommended that residents obtain insurance coverage.

APPLICATION FEE (nonrefundable). The application fee delivered by Applicant(s) to the Owner and/or its designated agent or representative in the
amount indicated below is to defray the cost of administrative paperwork and is nonrefundable.

APPLICATION DEPOSIT (may or may not be refundable). In addition to the application fee, Applicant(s) has delivered to the Owner or its designated
agent or representative an application deposit in the amount indicated below. The application deposit is not a security deposit. However, it will be
credited toward the required security deposit when the contemplated House or Townhouse Lease Contract has been signed by all parties; OR it will be
refunded if Applicant or any Co-Applicant is disapproved; OR it will be retained as liquidated damages if: 1) Applicant or any Co-Applicant is notified of
approval and fails to sign the contemplated House or Townhouse Lease Contract within 24 hours of having received notification of approval from Owner
or its agents or employees, or 2) decides not to rent the house for any reason after approval.

RECEIPT. Application fee (nonrefundable): $ 20.00

Application deposit (may or may not be refundable): $_______________
Total of above application fee and application deposit: $______________

MANAGER AND STAFF REPRESENT OWNER: Applicant(s) agree and understand that the Manager and all staff and employees of Owner
represent the Owner exclusively in the house application and leasing process. Applicant(s) further understand that they may, at their own
expense, select an agent or agents to represent them in the house application and leasing process.

VERIFICATION: I represent that all of the information in this House Rental Application is true and accurate to the best of my knowledge, and I acknowledge
that Owner and its agents or representatives will rely on this information in considering this application. All persons and/or firms named above may freely
give any requested information concerning me, and I hereby waive all right of action for any consequence resulting from such information. In the event
that any of the foregoing information is discovered to be false, I waive any rights that I may have under applicable law to notice or the establishment of
grounds for eviction and grant Owner or its agents or representatives the unconditional right to cancel my lease and immediately cause my eviction
without prior notice or the establishment of grounds for eviction.

_____________________________________________________________ LINDSEY MANAGEMENT CO., INC., Agent

Applicant Date

_____________________________________________________________ _____________________________________________
Applicant Date

CERTIFICATION: For the purpose of allowing Owner or Owner’s Agent or Representative to evaluate my application and determine my suitability as a
resident, I hereby certify that neither I nor any potential occupants of my home have ever been charged with or convicted of a felony or any crime
involving theft, violence, fraud, illegal drugs, or a sexual offense of any kind whatsoever.

___________________________________________________________ ____________________________________________________
Applicant Date Applicant Date

We do business in accordance with the Federal Fair Housing Law.

FOR OFFICE USE ONLY: IF APPLICATION ACCEPTED

_______________________________________________________________________________________________________________________
Address Apt. No. Telephone
$ $ $
Application Fee Amount Move-In Date Lease Expiration Date Application Deposit Amount Rent Paid at Move-in

Lindsey Management Company, Inc.-Homes Division HD-1101—07.14.11