Online Rental Application Today's Date* MM DD YYYY Move-In Date*SelectASAPNext 30 DaysSpring SemesterFall SemesterHow did you hear about us?*SelectFacebookGoogle SearchFriendPrinted AdvertisementCampus flyer/bulletin boardUA Off-Campus HousingWildcat/Wildcat onlineCraig’s ListOtherOther: Please Describe*What lease type would you prefer?*SelectWhole house, Joint & Several LeaseIndividual Lease, Furnished Common Areas, Internet includedIndividual Lease Location*Select a PropertySpeedway Office - Custom Home (5Br, 2Ba - Individual Lease)Whole House Lease Location*Select a Property4th Avenue Houses (5Br, 2Ba - Whole House)Blacklidge/Presidio Houses - (5Br, 2.5Ba - Whole House)Blacklidge/Presidio Houses (5Br, 2Ba - Whole House)Blacklidge/Presidio Houses (6Br, 3Ba - Whole House)Pima/Camilla Cottages (1Br, 1Ba)Pima/Camilla Cottages (2Br, 1Ba - Whole House)Pima/Camilla Cottages (Extra Large 1Br, 1Ba - Whole House)Pima/Camilla Cottages (Studio - Whole House)Pima/Camilla Cottages (Studio)Speedway House - Custom Home (5Br, 2Ba - Whole House) Personal InformationName* First Middle Last Permanent (parents) Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Social Security #*Birth Date* MM DD YYYY Sex*SelectMaleFemaleMarital Status*SelectSingleMarriedDriver's License #*Driver's License State*SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificDriver's License Expiration*No License Check here if you don't have a driver's license Current Phone #*Best Time(s) To CallHeight*Select4'0"4'1"4'2"4'3"4'4"4'5"4'6"4'7"4'8"4'9"4'10"4'11"5'0"5'1"5'2"5'3"5'4"5'5"5'6"5'7"5'8"5'9"5'10"5'11"6'0"6'1"6'2"6'3"6'4"6'5"6'6"6'7"6'8"6'9"6'10"6'11"7'0"7'1"7'2"7'3"Weight*Eye Color*SelectBlueBrownGreenVioletGreyHair Color*SelectBlondeLight BrownMedium BrownDark BrownBlackRedEmail* Enter Email Confirm Email Residence HistoryCurrent Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Complex NameMove-In Date*Current RentProperty Owner / ManagerProperty Owner / Manager Phone (Complete, if in current residence for less than 2 yrs please fill-in previous residence)Previous Address Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Complex NameMove-In DateCurrent RentProperty Owner / ManagerProperty Owner / Manager Phone Employment HistoryCurrent EmployerHow LongType of WorkEmployment Address Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor's Name First Last Supervisor's PhoneMonthly IncomeOther Income Source (if not employed) Guarantor(s)Guarantor Name #1* First Last IMPORTANT! Enter NA in the first and last name fields, if you are not using a guarantor.Guarantor Email #1* IMPORTANT! Enter NA in the email field, if you are not using a guarantor.Guarantor Phone #1*IMPORTANT! Enter 000-000-0000 in the phone field, if you are not using a guarantor.Guarantor Name #2 First Last Guarantor Email #2 Guarantor Phone #2 RoommatesRoommate #1 Name First Last Roommate #1 AgeRoommate #1 RelationshipRoommate #2 Name First Last Roommate #2 AgeRoommate #2 RelationshipRoommate #3 Name First Last Roommate #3 AgeRoommate #3 RelationshipRoommate #4 Name First Last Roommate #4 AgeRoommate #4 RelationshipRoommate #5 Name First Last Roommate #5 AgeRoommate #5 RelationshipRoommate #6 Name First Last Roommate #6 AgeRoommate #6 Relationship Financial ObligationsName of CreditorAccount NumberMonthly PaymentName of CreditorAccount NumberMonthly PaymentWhy are you leaving current residence?* General Information Click all that apply or "None of the above" if none applyHave You Ever* Been evicted? Broken a rental agreement? Declared bankruptcy? Been convicted of a felony? Been sued for nonpayment of rent or damage to rental property? None of the above Date you declared bankruptcy MM DD YYYY Emergency Contact InformationIn case of emergency please notify*Relationship*Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work PhoneHome Phone* Nearest RelativeNearest Relative Name* First Last Relationship*Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work Phone*Home Phone*Terms of Application * Application requires a non-refundable application fee to be processed. A Deposit to Hold is required at time of application. The Deposit to Hold is not a security deposit and will be applied to the first month’s rent and <strong>IS ONLY REFUNDABLE IN THE CASE OF DENIAL OF APPLICATION </strong>. The purpose of the Deposit to Hold is to secure the performance of the applicant(s)/resident(s) under the Lease Contract to move-in and to execute and deliver to Landlord all rental paperwork within stated period from the date of this application. THE DEPOSIT TO HOLD WILL BE FORFEITED AND BECOME NONREFUNDABLE IN THE EVENT THAT THE APPLICANT(S)/RESIDENT(S): 1. Fail to turn in and deliver to Landlord all rental applications, income verification or other documentation as required, within two weeks from the date of this application, 2. Fail to execute and deliver to Landlord all signed rental paperwork within one week of notification that rental paperwork is ready for signature and/or receipt of rental paperwork via any means. 3. Failure to deliver guarantor form, acceptable to Landlord – complete, signed and notarized, or alternate income documentation to substantiate sufficient income to meet all of the applicant’s financial responsibilities. Sufficiency and acceptability shall be at the sole discretion of the Landlord.</li> 4. Failure to move-in.Important Individual Leases for this home are only available to groups with five (5) residents. The entire Deposit to Hold together with substantially complete applications from the intended residents is required to hold the home. The home will remain on the market on a first come first served basis until that time. Should another group provide the complete Deposit and Applications before yours are complete, Landlord reserves the right to accept the completed group and in such case will refund any deposits received (excluding application fee and any credit/debit card fees) less a service fee of $200/resident. Important This home is leased under a single Joint and Several Lease. The entire Deposit to Hold together with substantially complete applications from the intended residents is required to hold the home. The home will remain on the market on a first come first served basis until that time. Should another group provide the complete Deposit and Applications before yours are complete, Landlord reserves the right to accept the completed group and in such case will refund any deposits received (excluding application fee and any credit/debit card fees) less a service fee of $200/resident. Acknowledgement and BillingI acknowledge reading the Terms of Application and my submittal is agreement to the terms set forth.* I Agree Application Fee* Price: $65.00 (A non-refundable application fee is required for each prospective resident)Deposit To Hold* Price: $200.00 Select Your Deposit*$400 DepositEnter amount for my portion of depositDeposit To Hold* Price: $400.00 Deposit To Hold* Price: $700.00 Select Your Deposit*$800 DepositEnter amount for my portion of depositDeposit To Hold* Price: $800.00 Select Your Deposit*$1,000 DepositEnter amount for my portion of depositDeposit To Hold* Price: $1,000.00 Select Your Deposit$1200 DepositEnter amount for my portion of depositDeposit To Hold* Price: $1,200.00 Deposit To Hold* You may divide the total required deposit any way you and your roommates choose. There is a $100 minimum per person and the deposit between all roommates must equal the total deposit in order to reserve the house* I Agree Debit/Credit Card Fee* Price: $0.00 Credit Card Fee* Price: $0.00 Debit Card Fee* Price: $3.00 Coupon Total $0.00 Is this a debit or credit card?*Debit Card - $3.00 fee per transactionCredit Card - 3% fee (based upon transaction amount)Credit / Debit Card* DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Billing Address Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Correct InformationThe undersigned person represents that all the above information is true and complete, and hereby authorizes verification of such information via credit report, rental history reports, and other means. Failure to answer any of the above inquiries shall entitle the owner to reject this application. False information given above shall entitle the Landlord to (1) reject this application, (2) retain the application fee(s), and (3) terminate resident’s right to occupancy. In any lawsuit relating to this application, application agreement or rights under statute or government regulations, the prevailing party is entitled to recover attorney’s fees and all other costs of litigation from the non-prevailing party. Correct Information The undersigned person represents that all the above information is true and complete, and hereby authorizes verification of such information via credit report, rental history reports, and other means. Failure to answer any of the above inquiries shall entitle the owner to reject this application. False information given above shall entitle the Landlord to (1) reject this application, (2) retain the application fee(s), and (3) terminate resident’s right to occupancy. In any lawsuit relating to this application, application agreement or rights under statute or government regulations, the prevailing party is entitled to recover attorney’s fees and all other costs of litigation from the non-prevailing party. Signature of Applicant*Date* MM DD YYYY Phone Number*PhoneThis field is for validation purposes and should be left unchanged.
