Application

RENTAL APPLICATION [email protected] | P 773.256.8704 | F 773.944.9422

PERSONAL INFORMATION

Move In Date:

FIRST NAME

MIDDLE

DATE OF BIRTH

MARITAL STATUS /

SINGLE ( )

/

PRIMARY PHONE

Unit:

Rent:

LAST MARRIED ( )

SS#

ENGAGED ( )

DIVORCED ( )

DOMESTIC PARTNER ( )

SECONDARY PHONE -

-

-

STATE

EMAIL CITY / STATE / ZIP

REASON FOR LEAVING

LANDLORD PHONE RENT AMOUNT

PREVIOUS ADDRESS

CITY / STATE / ZIP

LENGTH OF TIME

-

-

PRESENT HOME ADDRESS LENGTH OF TIME

DRIVER’S LICENSE #

PRESENT LANDLORD

PREVOUS LANDLORD

LANDLORD PHONE RENT AMOUNT

REASON FOR LEAVING

EVER MORE THAN (5) DAYS LATE?

( )Y

( )N

EVER MORE THAN (5) DAYS LATE?

( )Y

( )N

OCCUPANTS NAME

RELATIONSHIP

OCCUPATION

AGE

NAME

RELATIONSHIP

OCCUPATION

AGE

NAME

TYPE/BREED

NEUTERED/SPAYED?

AGE

NAME

TYPE/BREED

NEUTERED/SPAYED?

AGE

PETS

EMPLOYMENT / INCOME SOURCE CURRENT EMPLOYER / SOURCE OF INCOME (PRIMARY)

OCCUPATION

HRS / WK

EMAIL

YEARS EMPLOYED

ADDRESS

CITY / STATE / ZIP

MONTHLY SALARY/INCOME

CURRENT EMPLOYER / SOURCE OF INCOME (SECONDARY)

OCCUPATION

HRS / WK

EMAIL

YEARS EMPLOYED

CITY / STATE / ZIP

MONTLY SALARY/INCOME

SUPERVISOR

PHONE EXT.

SUPERVISOR

PHONE EXT.

ADDRESS

HAVE YOU EVER BEEN EVICTED? _____________ HAVE YOU EVER BEEN CONVICTED OF A FELONY? ______________ HAVE YOU BROKEN A LEASE? ______________ HAVE YOU EVER FILED BANKRUPTCY? _______________

To secure this apartment I understand I am responsible to submit, with this application, funds in an amount equal to one month’s rent and $40 credit check/application fee in the form of check, cash, money order, cashiers check or PayPal payment, made payable to ChiDomicile. With this payment in the amount of one month’s rent I indicate my desire to lease the above stated apartment. I understand and agree that these funds will be immediately deposited on the next business day and applied as first month’s rent of the lease. Upon signing this application I understand I have 48 hrs to submit all documentation/monies mentioned herein and am liable for said funds, in full, upon execution of this agreement. I further understand that these funds are forfeited if I am approved/offered the apartment and decide not to lease the apartment. I understand my payment in the amount of one month’s rent is refunded to me ONLY if my application is declined. __________ APPLICANT’S INITIAL INDIATES COMPLETE UNDERSTANDING OF THIS PARAGRAPH. I certify that I have reviewed the above application and that all the information contained therein is true, accurate and to my full understanding. I understand that this application shall be incorporated in and become part of the Lease of the Premises sought and if incorrect or untrue shall result in automatic default on the part of the applicant. If this application is accepted, I agree to rent the above premises under the terms and conditions set forth in the standard Chicago lease and fully intend to sign the formal lease immediately prior to or upon approval. Once approved, I have 48 hrs to execute all documents necessary to complete the rental transaction or will be considered in default of this agreement. This application and funds submitted are in good faith of my intent to finalize any and all details/payments/deposits and complete the rental transaction. If I fail to do so, THE DEPOSIT WILL BE RETAINED AS LIQUIDATED DAMAGES and I will be responsible for the lease in full until the apartment is re-rented. If this application is not accepted, the deposit will be refunded. I authorize ChiDomicile to run a credit report and confirm rental, employment and income verifications and any other background information necessary to validate my application information for a non-refundable fee of $40 plus the deposits held pending approval of this application.

APPLICANT’S SIGNATURE ________________________________________________________ PRINT NAME _______________________________________ DATE______________________

PARNTERING PEOPLE • EASING TRANSITIONS

5417 N Ashland Ave – Suite 2 | Chicago, IL 60640 Phone: 773.256.8704 | Fax: 773.944.9422 | Email: [email protected]

TO BE COMPLETED BY THE APPLICANT: I hereby authorize the release of rental information requested below for the purpose of processing my lease application.

________________________________ _____________________________________ ________________ Print Name

Applicant Signature

Date

__________________________________________________________________________________________

TO BE COMPLETED BY CURRENT LANDLORD / PROPERTY MANAGER: Name of Property Manager

________________________________

Address

________________________________ ________________________________

Phone/Fax Number

________________________________

To Whom It May Concern: This is to certify that

______________________________________________________ Name of Tenant(s)

lived at ____________________________________________________________________________ Address from _________________________ (Lease Start) to ________________________ (Lease End) Did tenant(s) pay their monthly rent on time? _____________________________________________________ Would you rent to tenant(s)again? ______________________________________________________________ Comments: ________________________________________________________________________________ __________________________________________________________________________________________ I certify that the above information is true and correct to the best of my knowledge. __________________________________ Print Name

________________________________ Signature

__________________________________ Title / Company

___________________ Date

We appreciate your prompt attention to this request in order to assist in expediting the approval of this applicant. PLEASE FAX TO: CHIDOMICILE - 773.944.9422

PARNTERING PEOPLE • EASING TRANSITIONS

5417 N Ashland Ave – Suite 2 | Chicago, IL 60640 Phone: 773.256.8704 | Fax: 773.944.9422 | Email: [email protected]

TO BE COMPLETED BY THE APPLICANT: I hereby authorize the release of employment/income information requested below for the purpose of processing my lease application. Applicant SSN: ___________ - ___________ - ____________ ________________________________ _____________________________________ __________________ Print Name

Applicant Signature

Date

__________________________________________________________________________________________

TO BE COMPLETED BY HUMAN RESOURCES/EMPLOYER: Name of the Employer

________________________________

Address

________________________________ ________________________________

Phone Number

________________________________

To Whom It May Concern: This is to certify that

_____________________________________________(Name of employee)

is working as __________________________(Position) since ____________________ (Approx. Start Date). He/She is holding a permanent position and his/her annual salary is ____________________ / year. I certify that the above information is true and correct to the best of my knowledge. __________________________________ Print Name

________________________________ Signature

__________________________________ Professional Title

___________________ Date

We appreciate your prompt attention to this request in order to assist in expediting the approval of this applicant. PLEASE FAX TO: CHIDOMICILE - 773.944.9422