CLEARVIEW VILLAGE APPLICATION FOR OCCUPANCY

FAILURE TO COMPLETE ALL SECTIONS AND SIGN WILL RESULT IN DELAY
Some fields are required in order to submit application online
     
Floor plan interested in:  
Today's date:   09-26-2023
Date you want to move-in:  
     
First Name:  
Middle Name:  
Last Name:  
Day Phone:  
Night Phone:  
Mobile Phone:  
Email Address:  
Social Security Number:  
Driver's License Number:  
Driver's License State:  
Date of Birth:  
     
Spouse Name:  
Social Security Number:  
Driver's License Number:  
Driver's License State:  
Date of Birth:  
     
     

CHILDREN / OTHER OCCUPANTS:
     
Name:  
Date of Birth:  
     
Name:  
Date of Birth:  
     
Name:  
Date of Birth:  
     
Name:  
Date of Birth:  
     
     
Pets?:   Yes  No
if Yes, please give a description of pet(s):  
     
Marital Status:  
Maiden Name:  
     
Are you a US citizen?   Yes  No
If No, what country are you a citizen of?  
     
In case of emergency, please notify    
Contact Name:  
Relationship to Tenant:  
Phone Number:  
Mobile Phone:  
Email Address:  
Address:  
City:  
State:  
Zip:  
     
How did you hear about us?  
     
     

RESIDENTIAL HISTORY
     
Present Landlord / Complex Name:  
Address:  
City:  
State:  
Zip:  
Date from:  
Date to:  
Phone Number:  
     
Previous Landlord / Complex Name:  
Address:  
City:  
State:  
Zip:  
Date from:  
Date to:  
Phone Number:  
     
     

PERSONAL REFERENCES
     
Name:  
Phone Number:  
Address:  
City:  
State:  
Zip:  
     
Name:  
Phone Number:  
Address:  
City:  
State:  
Zip:  
     
Name:  
Phone Number:  
Address:  
City:  
State:  
Zip:  
     
     

EMPLOYMENT / OTHER INCOME / FINANCIAL

**Please submit copies of your last (2) paystubs for employment and income verification.
Fax: 913.583.9868
Name of Employer:  
Employee Name:  
Position:  
Date from:  
Date to:  
Address:  
City:  
State:  
Zip:  
Phone Number:  
Income:  
Pay Schedule:  
     
Name of Employer:  
Employee Name:  
Position:  
Date from:  
Date to:  
Address:  
City:  
State:  
Zip:  
Phone Number:  
Income:  
Pay Schedule:  
     
     
OTHER INCOME: verification will be requested

Please list any SS, SSI, Pension, Disability, Student Grants, Child Support, Alimony, and all other sources of income.
Name:  
Amount:  
Type of Income:  
     
Name:  
Amount:  
Type of Income:  
     
     
BANKING INFORMATION
     
Account Type  
Financial Institution:  
Branch:  
Account #:  
     
Account Type  
Financial Institution:  
Branch:  
Account #:  
     
     

GENERAL QUESTIONNAIRE
     
Have you ever been evicted?   Yes  No
If Yes, please explain:  
     
Have you ever been convicted of a crime?   Yes  No
If Yes, please explain:  
     
Have you ever filed for bankruptcy?   Yes  No
If yes, When?  
     
Do you owe alimony?   Yes  No
If Yes, what amount?  
Are you past due on alimony?   Yes  No
If Yes, what amount are you past due?  
     
     
Do you owe child support?   Yes  No
If Yes, what amount?  
Are you past due on child support?   Yes  No
If Yes, what amount are you past due?  
     
     
Automobile Make:  
Model:  
Year:  
Color:  
License/Tag #:  
     
     
Automobile Make:  
Model:  
Year:  
Color:  
License/Tag #:  
     
     
Automobile Make:  
Model:  
Year:  
Color:  
License/Tag #:  
     

 


STATEMENTS FALSE OR INCOMPLETE INFORMATION WILL BE GROUNDS FOR DENIAL OF THIS APPLICATION.
THIS APPLICATION MUST BE SIGNED BY ALL ADULTS WHO WILL OCCUPY THE APARTMENT BEFORE IT CAN BE CONSIDERED BY LANDLORD. ACCEPTANCE OF THIS APPLICATION, AND ANY MONIES DEPOSITED HERE WITH THIS APPLICATION WILL BE HELD AS A RESERVATION DEPOSIT TO BE EITHER RETURNED TO APPLICANT OR CREDITED TOWARD ANY DEPOSIT WHICH MAY BE REQUIRED OF APPLICANT. NON-REFUNDABLE APPLICATION FEE: $0.00

I HEREBY GRANT THE PROPERTY OF CLEARVIEW CITY, THE RIGHT TO PROCESS THIS APPLICATION FOR THE PURPOSE OF OBTAINING A RENTAL/LEASE AGREEMENT WITH THIS PROPERTY. ADDITIONALLY, I AUTHORIZE ALL CORPORATIONS, COMPANIES AND LAW ENFORCEMENT AGENCIES, ACADEMIC INSTITUTIONS, AND CURRENT FORMER EMPLOYERS TO RELEASE INFORMATION THEY MAY HAVE ABOUT ME AND RELEASE THEM FROM ANY LIABILITY AND RESPONSIBILITY FROM DOING SO. A PHOTOGRAPHIC OR FAXED COPY OF THIS AUTHORIZATION SHALL BE VALID AS ORIGINAL.


 By checking this box I, WE authorize Clearview to run credit and criminal background checks.
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