Old South Apartment On-Line Application

Please complete this ENTIRE form for consideration at Old South Apartments.

Personal Information

Full Name (Last, First, Middle)	Social Security #	Birthdate(mm/dd/yyyy)

Present Address (Include Apt. #)	City/State	Zip

Best time for us to call you:(ex. mornings, etc...)	Home Phone #	Cell #

Spouse's Full Name (Last, First, Middle) (if applicable)	Social Security #	Birthdate(mm/dd/yyyy)

Other Occupants	Relationship	Age

Emergency Contact	Relationship	Phone ( )

Residence Information

Length in Current Residence: (ex.05/1999 until present)	Residence Type	Monthly Payment
	OwnRent
Mortgage Co. OR Apt. Name	Phone Number ( )	Contact Person

Work History

Current Job Title	Employer's Name	Phone Number ( )

Annual Income	Supervisor's Name	Dates at Current Job (ex.02/2000-present)

Previous Job Title	Previous Employer's Name	Phone Number ( )

Previous Annual Income	Previous Supervisor's Name	Dates at Previous Job (ex.08/1997-02/2000)

Spouse's Current Job Title	Spouse's Employer's Name	Phone Number ( )

Spouse's Annual Income	Spouse's Supervisor's Name	Dates at Current Job (ex.02/2000-present)

Additional Financial Information

Other Sources of Income (IF APPLICABLE)	Amount	Description

Credit Reference	Account Number	Location

Credit Reference	Account Number	Location

Bank Reference	Account Number	Location

Vehicle/Pet Information

Automobile #1 Make/Model/Year (ex. Chrysler/LeBaron/1996)	Driver's License #1	License Plate #1

Automobile #2 Make/Model/Year (ex.Chrysler/LeBaron/1996)	Driver's License #2	License Plate #2

Do you have pets?YesNo	If you answered 'YES' to having pets, you must complete the following about your pets.
Pet #1 Type(specific)	Height	Weight

Pet #2 Type(specific)	Height	Weight

If you have pets, do you have more than 2? YesNo

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SUBMITTING FORM

CORRECT INFORMATION - Applicant represents that all of the above statements are true and complete, and hereby authorizes verification of above information, references and credit records. Applicant acknowledges that false information herein may constitute grounds for rejection of this application, termination of right of occupancy, and/or forfeiture of deposits and may constitute a criminal offense under the laws of this state. Applicant agrees to the terms of the Application Deposit Agreement below.

APPLICATION DEPOSIT AGREEMENT - Applicant has depositied an "Application Deposit" ( in the amount stated) in consideration for owner's taking the dwelling unit off the market while considering approval of this application. If applicant is approved by owner, and the contemplated lease is entered into, the application deposit shall be credited to the required security deposit. If applicant is approved but fails to promptly enter into the contemplated lease, the applicant deposit shall be forfeited by owner. The application deposit will be refunded only if applicant is not approved. Keys will be furnished only after contemplated lease and other rental documents have been properly executed by all parties and only after applicable rentals and security deposits have been paid. This application is preliminary only and does not obligate owner or owner's agent to execute lease or deliver posession of the proposed premises.

**By Placing your initals below, you are verifying that you have read and agree to the provisions as stated.

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