Rental Application
Total Rent $_________ Total Each $_________
Total Deposit $_________ Total Each $_________
Property Address Unit # Property Code

1. _________________________________________________ Renewal
[ ]		 TENANT CODE _______ Date Ck # called
  Name Social Security #     Deposit owed $______    
  _________________________________________________ ENTERED Balance owed $______    
  Local Address   Local Phone __/__/__ Balance owed $______    
  _________________________________________________ MOVED IN Balance owed $______    
  Home Address   Home Phone __/__/__ Balance owed $______    

2. _________________________________________________ Renewal
[ ]		 TENANT CODE _______ Date Ck # called
  Name Social Security #     Deposit owed $______    
  _________________________________________________ ENTERED Balance owed $______    
  Local Address   Local Phone __/__/__ Balance owed $______    
  _________________________________________________ MOVED IN Balance owed $______    
  Home Address   Home Phone __/__/__ Balance owed $______    

3. _________________________________________________ Renewal
[ ]		 TENANT CODE _______ Date Ck # called
  Name Social Security #     Deposit owed $______    
  _________________________________________________ ENTERED Balance owed $______    
  Local Address   Local Phone __/__/__ Balance owed $______    
  _________________________________________________ MOVED IN Balance owed $______    
  Home Address   Home Phone __/__/__ Balance owed $______    

4. _________________________________________________ Renewal
[ ]		 TENANT CODE _______ Date Ck # called
  Name Social Security #     Deposit owed $______    
  _________________________________________________ ENTERED Balance owed $______    
  Local Address   Local Phone __/__/__ Balance owed $______    
  _________________________________________________ MOVED IN Balance owed $______    
  Home Address   Home Phone __/__/__ Balance owed $______    

5. _________________________________________________ Renewal
[ ]		 TENANT CODE _______ Date Ck # called
  Name Social Security #     Deposit owed $______    
  _________________________________________________ ENTERED Balance owed $______    
  Local Address   Local Phone __/__/__ Balance owed $______    
  _________________________________________________ MOVED IN Balance owed $______    
  Home Address   Home Phone __/__/__ Balance owed $______    

6. ___________________________________________________________ Renewal [ ] TENANT CODE _______ Date Ck # called
  Name Social Security #     Deposit owed $______   /  /    
  ___________________________________________________________ ENTERED Balance owed $______   /  /    
  Local Address   Local Phone __/__/__ Balance owed $______   /  /    
  ___________________________________________________________ MOVED IN Balance owed $______   /  /    
  Home Address   Home Phone __/__/__ Balance owed $______   /  /    

Are applicants over the age of 18?_____________________
Who is your contact person?_________________________		 To persons applying for a lease understand that this form is only an application to lease. It is not a lease agreement.
And, it is not an agreement by either the person making application or the landlord [landlord's Representative] to enter into a lease agreement. By making this application, permission is granted for credit/reference checks to be made.

……………………………………………………………………………………………………………………
CONSUMER NOTICE FOR TENANTS THIS IS NOT A CONTRACT


(Not to be used when licensee is subagent for the landlord, agent for the tenant or transaction licensee)
Thomas S. Mitros (Licensee) hereby states that with respect to this property 
(describe property) _________________________________________________________________
I am acting in the following capacity: (check one)
[ ] Owner/Landlord of the Property
[ ] A direct employee of the Owner/Landlord; OR
[ ] An agent of the Owner/Landlord pursuant to a property management or exclusive leasing agreement
I acknowledge I have received this notice: 
____________________________________________ __________________
(Consumer) (Date)

____________________________________________ ___________________
(Consumer) (Date)

I certify that I have provided this Notice:
____________________________________________ ___________________
(Licensee) (Date)