This form is for your convenience. We do require a $45 application fee
that can be paid securely on-line. After you submit your on-line application you
will be directed to a secure processing page and prompted to enter your credit/debit card payment information. If
you would also like to hold a home while we process your application please call
the office at 614-433-9100.
Applications will not be processed until payment receipt is confirmed. The online application on this page
is shorter than the printable application. If you are approved for a home, you
may be required to fill out our full application and provide additional
documentation. If you are not comfortable sending the information online
you may click here
for a printable
version of our application that you can complete and mail to us with your
application fee. We accept
First Name
*
Middle Name
*
(if you have no middle name type "none")
Last Name
*
Social Security Number
*
(xxx-xx-xxxx)
Date of Birth
*
Driver License Number
Driver License State
Driver License Expiration Date
Work Phone
Ext.
Home Phone
*
Cell Phone
E-mail
*
Spouse/Co-Applicant Information
First Name
Middle Name
Last Name
Social Security Number
(xxx-xx-xxxx)
Date of Birth
Driver License Number
Driver License State
Driver License Expiration Date
Work Phone
Ext.
Home Phone
Cell Phone
E-mail
Current Address Information
Street Address
*
Address (cont.)
City
*
State/Province
*
Zip/Postal Code
*
Own Or Rent
*
Manager/Landlord Name
*
Manager/Landlord Phone
Move In Date
*
Move Out Date
*
Current Monthly Rent
*
Reason for Move
*
Previous Address Information
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Rent or Own
Manager/Landlord Name
Manager/Landlord Phone
Move In Date
Move Out Date
Previous Monthly Rent
Reason for Move
Pet Information
Pets
*
If yes, describe pets (breed, male/female,
weight, spayed/neutered, age)
Applicant Employment Information
Self Employed
Employer
*
Street Address
*
Address (cont.)
City
*
State/Province
*
Zip/Postal Code
Date Hired
*
Position
*
Supervisor's Name
*
Employer Phone
*
Ext
Monthly Income Before Taxes
*
Spouse/Co-Applicant Employment Information
Self Employed
Employer
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Date Hired
Position
Supervisor's Name
Employer Phone
Ext
Monthly Income Before Taxes
Other Income Information
Other Source of Income
Monthly Amount
Person to Verify Amount
Phone
Ext
Total Sum of Monthly Income From All Sources
(Applicant & Co-App)
*
Applicant Expense Information - Enter 0 if a payment does not exist
Other (List amounts and description of each
expense)
Total of Monthly Expenses
listed above
Other Occupants
Name
Age
Name 2
Age
Name 3
Age
Name 4
Age
Name 5
Age
Name 6
Age
Please answer the following questions:
List any allergies you
or any future occupant have. If none, state "none":
*
Have you or any occupant ever broken a lease?
*
If yes, date
If yes, details
Have you or any occupant ever been charged with a
crime?
*
If yes, date
If yes, details
Please enter the information of the property you wish to lease:
Address
*
City
Date you wish to occupy home
*
Deposit/Down Payment you have available
*
Please enter comments or questions below:
Agreement:
By submitting this application, you are accepting the following terms. I/WE, AUTHORIZED MR. KNOPPE AND ANY COMPANY OR PERSON HE MAY
CONTACT TO SUPPLY ANY AND ALL INFORMATION NECESSARY REGARDING OUR BANKING
ACTIVITY, CREDIT HISTORY, POLICE AND/OR CRIMINAL RECORDS AND EMPLOYMENT
HISTORY. CREDIT RECORDS MAY BE OBTAINED NOW AND IN THE FUTURE FOR AS
LONG AS MONEY IS OWED ON AN ACCOUNT. I/WE UNDERSTAND THAT
MISREPRESENTATIONS OR CONCEALMENT RELATIVE TO ANY OF THE ABOVE FACTS COULD
CAUSE THE APPLICATION TO BE REJECTED. Houses may be held
for future occupancy with a deposit. Contact us at 614-433-9100 if you
would like to hold a home with a deposit. We operate on a first come,
first serve basis regarding holding a home with a deposit.
