RIVERMILL APARTMENT CREDIT APPLICATION
Date: _________ Interested in: Renting Property Address: ________________________
Name:
(First) (Middle) (Last Jr./Sr.)
Birth date: / / Soc. Sec. No: / / Home Phone: ( ) -
Address:
(Street/P.O. #) (State) (Zip)
Name:
(First) (Middle) (Maiden)
Birth date: / / Soc. Sec. No: / /
EMAIL ADDRESS:_______________________________________________________________________
IN CASE OF EMERGENCY CALL: _________________________________________________________
EMPLOYMENT INFORMATION
Present Employer: Occupation:
Address: Phone: ( ) -
Hourly pay: $ ________ Paid: Wk. Bi-Wk. Mo. Take-home $ _________ Date Employed: ______
Previous Employer: Reason for leaving:
Employer: Occupation:
Address: Phone: ( ) -
Hourly pay: $ ________ Paid: Wk. Bi-Wk. Mo. Take-home $ _________ Date Employed: ______
Previous Employer: Reason for leaving:
OTHER INFORMATION
Landlord:________________________________________Phone: ( ) -______________________
Other Income:
Monthly obligations (i.e. car payments, child support, credit cards, etc.):
__________________________________________________________________________________________
CREDIT REFERENCES
Name Address Phone
1.
2.
3.
COMPLETE THIS SECTION ONLY IF INTERESTED IN RENTING
Interested in a _____ bedroom apartment Date needed: ______________________________
Number of children at home: ___________________ Ages: ____________________________________
Pets: Number: _______________ Breed: _____________________________________________________
NOTE: Pit Bulls, Doberman Pinchers, Great Danes, Rotweilers
are not allowed. All pets subject to approval of landlord.
Referred by: Website Apartment Guide Village Adocate
Other ____________________________________________________________________
I have provided true information to the best of my knowledge. I further authorize the above cited references to supply pertinent information as may be required to determine my/our credit capabilities. YOU HAVE MY/OUR PERMISSION TO VERIFY THE ABOVE INFORMATION AND OBTAIN OUR CREDIT REPORT.
________________________________________ ________________________________________
Agent Signed
________________________________________ ________________________________________
Date Signed
OFFICE USE ONLY
Price of Property: $______________ Total Monthly Income: $ _________ Total Expenses: $_____________
Net Income: $ _________________ Monthly Payment: $_____________
Percentage of Income Amount of Home
Payment not to exceed 28% of gross income:
Total obligations not to exceed 36% of gross income:
Jordan Properties: P.O. Box 128, Saxapahaw, NC 27340
Phone: 336-376-3122 Fax: 336-376-3522