Page Management

RESIDENTIAL RENTAL APPLICATION

Please Copy and Paste the Information Below after Filling Out and Fax to:  (212) 219-8079

INSTRUCTIONS

Residential Rental Application

Date of Application:
Please Indicate How You Found Out About this Apartment:
Rental Amount:
Lease Term Desired:
Application Made In Conjunction With:

Personal Information:


NAME:
DAYTIME TELEPHONE:
SOCIAL SECURITY NUMBER:
DRIVER'S License NUMBER:
PRESENT ADDRESS:
PRESENT LANDLORD /MORTGAGOR:
NAME:
ADDRESS:

PHONE:
MONTHLY RENT/MORTGAGE:
REASON FOR MOVING:


FINANCIAL INFORMATION
Employer:
NAME:

ADDRESS:
PHONE NUMBER:
CONTACT PERSON:

INCOME:
POSITION:
LENGTH OF EMPLOYMENT:
TOTAL ANNUAL INCOME:

BANK NAME:

ADDRESS:
PHONE NUMBER:
ACCOUNT NUMBER:
CONTACT PERSON:
REFERENCES


BUSINESS REFERENCES
NAME:
ADDRESS:
DAYTIME PHONE:
PERSONAL

NAME:
ADDRESS:
DAYTIME PHONE:

NAME:
ADDRESS:
DAYTIME PHONE:

PERSONAL REFERENCES
NAME:
ADDRESS:
DAYTIME PHONE:
NAME:

NAME:
ADDRESS:
DAYTIME PHONE:
NAME:
ADDRESS:
DAYTIME PHONE:


CAN YOU PROVIDE A GUARANTOR IF IT IS DETERMINED THAT DUE TO INCOME OR OTHER REASONS THIS IS NEEDED FOR YOUR LEASE? (YES, N0 OR EXPLANATION)



AGREEMENT BETWEEN APPLICANT AND LESSOR
Applicant certifies and represents that all information on his Application is correct, and that, except as explained below, the following conditions are true: that they are not breaking their lease, that they have paid all rent/mortgage payments in a timely manner for the past twelve months, that they have received no notices of eviction or Lease Termination, that they have not filed for bankruptcy within the last five years that they are presently financially solvent. Application is not complete until photo identification is provided to Lessor.

DEPOSIT POLICY
A deposit equivalent to one month's rent must accompany all rental applications. Two hundred dollars of this amount must be in cash, certified check, or money order. In the event you are not offered the apartment, all money will be returned to you promptly. If the apartment is offered to you and you do not accept this apartment or you withdraw this application, Lessor will retain all deposit moneys as liquidated damages for withdrawing the unit from the rental market. If you (and your guarantor, where applicable) do not sign the lease within 24 hours after being notified that your application has been approved, all deposit moneys will be retained as liquidated damages.
I hereby authorize the Lessor and Page Management Co., Inc. and it's agents to verify all information I provide, including obtaining a credit report from a credit-reporting agency.

DATE
Signature