WaiverForever

Rental Application Form  PROPERTY APPLYING FOR: ACC APARTMENT  Applicant Type Personal Information Name Date of Birth Social Security Phone Alternate Phone Email Address Income Sources  Roommates / Other Occupants Please list your three most recent addresses or from past five years  Other Information Have you ever been evicted Have you ever been convicted of a felony Have you ever filed for bankruptcy Do you currently smoke Do you have any pets If Yes, please provide details or put N/A Agreement & Signature I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification of information I provided and communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for a home or apartment and does not constitute a rental or lease agreement in whole or part. I further understand that there is a non-refundable fee to cover the cost of processing my application and I am not entitled to a refund. Your signature Date