Central New York Apartments
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Our Rental Application

Please complete all requested information on this form. Thank you for your interest in our apartments.

*Asterisks Below Denotes Required Data Fields
**Double Asterisks Below Denotes Required Data Fields if a Co-Applicant is Used

Apartment Information

*Apartment Complex Your Are Applying For:
*How Did You Hear About Our Property?
*Type and Size of Apartment Wanted (No. Bedrooms, Etc.)
*Desired Date of Occupancy

Personal Information

*Applicant's Full Name
*Date of Birth
*Social Security No.
*Driver's License No. & State
**(If Applicable) Co-Applicant's Full Name
**Date of Birth
**Social Security No
**Driver's License No. /State
*Full Names of All Other Residents (If Applicable)

1. Name Relationship Date of Birth
2. Name Relationship Date of Birth
3. Name Relationship Date of Birth

Residence History

*Present Street Address
*City, State Zip
*Present Telephone
Cell Phone
*Landlord or Mortgage Co.
*Landlord Phone
*Monthly Payment $
*Reason For Moving
Previous Street Address
City, State Zip
Resided There From & To (Enter Dates)
Landlord or Mortgage Co.
Landlord Phone
Monthly Payment $
Reason For Moving

Employment History

*Present Employer
*Employer's Address
*Gross Monthly Salary
Past Employer
Employer's Address
Gross Monthly Salary
**(If Applicable) Co-Applicant's Employer
**Employer's Address
**Gross Monthly Salary

Credit History

*Credit Reference 1
*Account No
*Credit Reference 2
*Account No
Other Reference

Vehicle Information

*Total Number of Vehicles (Including Company Vehicles)
*Vehicle 1: Make/Model, Year, Color, Tag No., State
Vehicle 2: Make/Model, Year, Color, Tag No., State
Other Car, Motorcycle, Etc.?

Income Information

*Total Gross Monthly Household Income $
If There Are Other Sources of Income You Would Like Us To Consider, Please List Income, Source And Person' (Banker, Employer, Etc.) Who We Could Contact For Confirmation. You Do Not Have To Reveal Alimony, Child Support or Spouse's Annual Income Unless You Want Us To Consider It In This Application.
1. Amount Per Month $
2. Amount Per Month $

Other Information

Have You or Co-Applicant Ever:
*Been Sued For Non-Payment of Rent?
*Been Evicted or Asked To Move Out?
*Broken A Rental Agreement or Lease?
*Been Sued For Damage To Rental Property?
*Declared Bankruptcy?
In Case of Personal Emergency, Please Notify:
*Emergency Contact's Name
*Home Phone
*Work Phone
Do You Have Any Comments?
Terms & Conditions
I Hereby Make Application For An Apartment And Certify That This Information Is Correct. I Authorize You To Contact Any References That I Have Listed. I Also Authorize You To Obtain My Consumer Credit Report From Your Credit Reporting Agency Which Will Appear As An Inquiry On My File.

*Please Note: If A Deposit Is Given To Hold An Apartment And The Applicant Cancels; Then The Deposit Will Be Forfeited.
By typing your full name below you are affirming and agreeing to the terms and conditions in the box above. The eSignature must match exactly the name as you entered it at the top of this form.
*Applicant's eSignature:
*Date eSigned:
**Co-Applicant's eSignature:
**Date eSigned:
Spam Guard: ← Enter the red number in this field: 31

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