Rental Application

Sterling Real Estate Management LLC RENTAL APPLICATION Phone (516) 482-4820 FAX Back To : (516) 482-1212 Building Address: ______________________________________ Application For Apt:________ Monthly Rent____________ Date of Application____________ Lease Start Date______________

Full Name_______________________________________*Date of Birth ____ -- _____---________ S.S.#______-____ -_____ E-Mail:_____________________Cell Phone#( )_____________ Home#( )_______________ Work #( )______________ In Case of Emergency: Contact:_______________________________Telephone( )________________________ ___________________________________________________________________________ Other Residents 1._________________________________Relationship Age_if under 18__________ 2._________________________________Relationship Age_if under 18__________ Do you have any pets?_______ Please specify___________________

RESIDENTIAL HISTORY Address____________________________________________ City:__________________State:_________Zip Code:_________ Telephone________________________________Length here:______________Reason Moving___________________________ Monthly Rent $__________________Landlord__________________________________Landlord Telephone_________________ Address_____________________________________________City:___________________State:________Zip Code:_________ Length here:____________Monthly Rent $___________Landlord_____________________Landlord Telephone_____________

EMPLOYMENT INFORMATION Employer________________________________________Supervisor_________________________Start Date:_______________ Employer’s Address______________________________________________Telephone________________________________ Annual Income $__________________ Position ____________________ Bonus $___________ Housing Allowance $_________ Previous Employer________________________________Supervisor_________________________Dates___________________ Previous Employer’s Address______________________________________Telephone_________________________ Annual Income $________________ Position ____________________ Bonus $_____________ Housing Allowance $_________

BANKING AND PROFESSIONAL REFERENCES Bank_____________________________Address_______________________________ Banking Officer_________________________Telephone( )___________________ Checking Account #_____________________Savings Account #________________________ Attorney_______________________________Telephone( )___________________ Accountant____________________________ Telephone( )___________________

AUTHORIZATION The Owner will in no event be bound nor will possession be given, unless and until a lease executed by the Owner has been delivered to the Tenant. The applicant and his references must be satisfactory to the Owner. No representations or agreements by agents, brokers or others are binding on the Owner or on any Agent unless included in the written lease proposed to be executed. I hereby warrant that all my representations set forth above are true. I further represent that I am not renting a room or an apartment under any other name, nor have I ever been dispossessed from any apartment, nor am I now being dispossessed. I represent that I am over 18 years of age. I authorize the verification of the above-referenced information and its release to the Owner, Managing Agent or other parties connected with the lease contemplated herein. I authorize a credit search by name and social security number, at this time, and at anytime during my tenancy. I will present any other information required by the Owner or Managing Agent in connection with the lease contemplated herein. I understand that all credit fees are non-refundable once this application is submitted to the Owner.

Signature_____________________________________________________________ Date_________________________________________

*Date of birth is being requested only for the purpose of identification in obtaining accurate retrieval of records, and will not be used for discriminatory purposes.