I have read and agree to the Application Agreement. Click Here to read Application Agreement.
Application Fees are 50.00 per person (over the legal age) and 75.00 per couple.
(NOTE:  An application will not be processed until fees are received.)
Property Information
Property Address:
Date you will take occupancy:
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Date Submitted

12-11-2017
Applicant type: Individual   Co-Applicant
Applicant Information
First:
Middle:
Last:
Date of Birth:
Click Here
SSN:
Home Number:
Cell Number:
Email:
Driver License #:
State:
Expires: Click Here
Automobile Information
Make:
Model:
Year:
Color:
License plate#:
State:

Make:
Model:
Year:
Color:
License plate#:
State:

Any other name(s) used (including maiden name): 
Residential History
Current Address
Street1:
Street2:
City:
State: Zip:
Residency: Rent   Own
Previous Address
Street1:
Street2:
City:
State:
Zip:
Residency:
Rent   Own
Employment Information
Are you Retired?
Yes No
Current Employer
Employer:
Address:
City:
State:
Zip:
Phone Number:
  Ext:
Supervisor Name:

Supervisor Number:
  Ext:

Your Title/Position:

Monthly Income:
Start Date:
Click Here
Are you Self-Employed?
Yes No
Previous Employer
Employer:
Address:
City:
State:
  Zip: 
Phone Number:
  Ext:
Supervisor Name:

Supervisor Number:
  Ext:

Your Title/Position:

Monthly Income:
Start Date:
Click Here
End Date:
Click Here
Applicant Questions
Have you ever been asked to move out of a residence?
Yes   No

Have you ever been party to an eviction?
Yes   No
Are you a registered sex offender?
Yes   No
Have you or any member of your household been convicted or pleaded no contest to a felony?
Yes   No


Do you have liquid furniture? (i.e. waterbed)
Yes   No

Do you have renter insurance?
Yes   No
Have you ever filed bankruptcy?
Yes   No
Have you ever had any collections?
Yes   No
Pets
Do you have Pets?
Yes   No
Other Occupants (Type a last name then hit Tab to add another occupant.  The maximum is six.)
Please list all people who will reside in the residence:
First: MI: Last:   Relation: Date of Birth: Click Here Gender:

Emergency Contact:
First:
Middle:
Last:
Home Phone:
Cell Phone:
Street1:
Street2:
City:
State: Zip:
Nearest Relative (Not residing in the property.):
First:
Middle:
Last:
Home Phone:
Cell Phone:
Street1:
Street2:
City:
State: Zip:

Financial Information
Bank NameAccount TypePhone
Credit Reference NameAccount TypeBalance




Do you own a home or other real estate? Yes   No

Additional Income SourceMonthly Income
Pension
Social Security and/or SSI
Alimony
Child Support
AFDC/Government Assistance
Unemployment Compensation
Other
Additional Comments or Notes
Application Completion

CONDITIONS OF PROPERTY – The property will be leased in the same condition as it is shown unless otherwise agreed to in writing.

SPECIAL PROVISIONS - You hereby deposit Equal to One Month’s Rent t as earnest money to be refunded to you if this application is not accepted. Upon acceptance of this application, this deposit shall be retained as part or all of the security deposit. After being notified of your acceptance, you will enter into a lease agreement within 3 day of acceptance. If you choose not to enter into a lease agreement the deposit Equal to One Month’s Rent will be forfeited as liquid damages in payment for time and effort in processing the application, marketing and rental expenses related to re-renting the reserved property. Regardless of circumstances if you do not enter into a lease agreement within 3 days after acceptance of the application the deposit will be forfeited and is non refundable. 

                  

RENTER’S INSURANCE NOTICE – You are hereby notified that while the landlord carries fire and casualty insurance on the property, it covers only the premises and not your possessions. The Landlord’s insurance does not cover your personal liability. Therefore, you must purchase renter’s insurance to insure your possessions against loss from fire, water or other source. Coverage should include a liability clause. The Landlord’s insurance does not cover damages for fires or flooding to your property. If you are the direct cause of damages, you are then responsible for the repair of the Landlord’s property and the replacement of all damaged items belonging to the Landlord. Failure to comply will result in your eviction from the premises. We require you to obtain a tenant’s insurance policy. As a condition of the lease you will be required to have proof of renter’s insurance at the lease signing.

                            

AUTHORIZATION TO VERIFY INFORMATION – Applicants acknowledge that the information provided on the rental application is true and correct and hereby authorize VERDE Management LLC, (Landlord or Broker) to obtain a consumer report (credit report), Rental History, Employment / salary details, Court Evictions Search, Criminal Background Report, Sex Offender Search, and Terrorism Search to verify the information contained here, and to report any information obtained to the Landlord.  Applicants also authorize VERDE Management LLC to re obtain any of this information at any time during or after their residency in order to pursue collection of any monies owed to VERDE Management LLC. Applicants’ social security numbers are provided for this purpose.  Applicants acknowledge that if they present false information the Landlord may reject this application. Applicants understand that giving false or incomplete information may result in forfeiture of any payments made in connection with this Rental Application. The verification of information provided by applicants is VERDE Management LLC’s best effort to deal with criminal activity within our communities. Assume responsibility for your own safety. VERDE Management LLC cannot guarantee or promise personal safety.

                                            

THIRD PARTY VERIFICATION – I hereby authorize all third parties indicated on my application to furnish the information requested below to VERDE Management LLC and its partnerships. I release the third parties, their officers, agents and employees from any and all liability, which may result by breach of compliance with the verification request.

I, the undersigned Applicant, agree to the above terms and do hereby swear (or affirm) that the information supplied herein is true and complete, to the best of my knowledge and belief.  By clicking "Apply Now" you agree to the terms stated above.  Please enter your full name to signify your digital signature, thereby confirming that you have read and agree with all the above statements and have provided complete and accurate information.  Applicant authorizes verification of references given and declares that the statements made in this application are true and correct and agrees that the landlord may terminate the contract entered into in reliance on any misstatement made in this application.


APPLICANT SIGNATURE: 



   
Database Info:  HAUENSTN_132908  Verde_Management