This application will be made part of a lease entered into by the Landlord and Resident(s), if and when
the lease is executed. As a part of the lease for which this application is made, the undersigned
applicant(s) agrees that falsifying any information on this document or the breach of any one or more of
its covenants is grounds for the Landlord/Owner to cancel the lease and obtain restitution of the
premises and/or money damages.
A separate application and application fee are required of each occupant over the age of 18. It is
further agreed and I hereby authorize the Owner/Landlord/Representative to inspect and examine any and
all records pertaining to: my credit which is maintained by the credit bureau, criminal background, my
rental history and employment verification on a continuing basis throughout the term of this lease or to
reexamine or re-inspect any of the foregoing. It is agreed, a facsimile signature shall stand in place
of and stead of applicant’s original signature
I (we) hereby make an application for lease for the above described premises and services, on the terms
above specified and pay $75.00 per applicant as an application fee for preparing paperwork, checking and
reviewing credit. The deposit will be required once the application has been processed. The deposit is
forfeited if the applicant wishes to cancel the application AND 72 hours have passed. It is understood
that the application fee is not refundable.
If you accept this application and deliver a lease to me (us) for execution on the above terms in the
form prepared by you, I (we) shall thereafter execute and deliver the same to you.. If I (we) fail or
refuse to execute and deliver the said lease to you, then the security deposit made herewith is to be
retained by you as liquidated damages, and there shall be no further liability on the part of the owner
or the undersigned in respect to said proposed lease or this application.
This application shall not be binding upon the owner until accepted in writing. The delivery of a lease
to the undersigned for signature shall not be construed as acceptance of this application nor shall such
lease be binding upon the owner until it has been executed on the owner’s behalf and delivered to the
undersigned.