CLEARVIEW VILLAGE APPLICATION FOR OCCUPANCY
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FAILURE TO COMPLETE ALL SECTIONS AND SIGN WILL RESULT IN DELAY Some fields are required in order to submit application online
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Floor plan interested in: |
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Today's date: |
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06-02-2023 |
Date you want to move-in: |
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First Name: |
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Middle Name: |
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Last Name: |
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Day Phone: |
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Night Phone: |
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Mobile Phone: |
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Email Address: |
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Social Security Number: |
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Driver's License Number: |
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Driver's License State: |
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Date of Birth: |
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Spouse Name: |
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Social Security Number: |
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Driver's License Number: |
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Driver's License State: |
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Date of Birth: |
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CHILDREN / OTHER OCCUPANTS:
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Name: |
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Date of Birth: |
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Name: |
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Date of Birth: |
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Name: |
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Date of Birth: |
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Name: |
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Date of Birth: |
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Pets?: |
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Yes
No
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if Yes, please give a description of pet(s): |
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Marital Status: |
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Maiden Name: |
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Are you a US citizen? |
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Yes
No
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If No, what country are you a citizen of? |
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In case of emergency, please notify |
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Contact Name: |
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Relationship to Tenant: |
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Phone Number: |
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Mobile Phone: |
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Email Address: |
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Address: |
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City: |
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State: |
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Zip: |
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How did you hear about us? |
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RESIDENTIAL HISTORY
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Present Landlord / Complex Name: |
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Address: |
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City: |
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State: |
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Zip: |
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Date from: |
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Date to: |
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Phone Number: |
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Previous Landlord / Complex Name: |
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Address: |
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City: |
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State: |
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Date from: |
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Date to: |
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Phone Number: |
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PERSONAL REFERENCES
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Name: |
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Phone Number: |
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Address: |
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City: |
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State: |
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Zip: |
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Name: |
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Phone Number: |
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Address: |
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City: |
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State: |
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Zip: |
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Name: |
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Phone Number: |
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Address: |
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City: |
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EMPLOYMENT / OTHER INCOME / FINANCIAL
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**Please submit copies of your last (2) paystubs for employment and income verification.
Fax: 913.583.9868
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Name of Employer: |
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Employee Name: |
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Position: |
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Date from: |
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Date to: |
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Address: |
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City: |
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State: |
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Zip: |
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Phone Number: |
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Income: |
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Pay Schedule: |
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Name of Employer: |
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Employee Name: |
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Position: |
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Date from: |
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Date to: |
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Address: |
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City: |
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State: |
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Zip: |
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Phone Number: |
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Income: |
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Pay Schedule: |
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OTHER INCOME: verification will be requested
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Please list any SS, SSI, Pension, Disability, Student Grants, Child Support, Alimony, and all other sources of income.
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Name: |
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Amount: |
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Type of Income: |
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Name: |
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Amount: |
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Type of Income: |
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BANKING INFORMATION
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Account Type |
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Financial Institution: |
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Branch: |
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Account #: |
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Account Type |
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Financial Institution: |
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Branch: |
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Account #: |
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GENERAL QUESTIONNAIRE
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Have you ever been evicted? |
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Yes
No
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If Yes, please explain: |
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Have you ever been convicted of a crime? |
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Yes
No
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If Yes, please explain: |
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Have you ever filed for bankruptcy? |
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Yes
No
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If yes, When? |
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Do you owe alimony? |
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Yes
No
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If Yes, what amount? |
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Are you past due on alimony? |
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Yes
No
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If Yes, what amount are you past due? |
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Do you owe child support? |
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Yes
No
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If Yes, what amount? |
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Are you past due on child support? |
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Yes
No
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If Yes, what amount are you past due? |
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Automobile Make: |
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Model: |
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Year: |
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Color: |
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License/Tag #: |
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Automobile Make: |
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Model: |
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Year: |
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Color: |
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License/Tag #: |
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Automobile Make: |
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Model: |
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Year: |
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Color: |
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License/Tag #: |
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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.