Country Manor Apartments: Submit a rental application

Country Manor Apartments Rental Application

Every occupant over the age of 18 MUST fill out a separate application (even if married). Please fill out this form COMPLETELY and sign where indicated. If you prefer, you can download a PDF version of the application and mail it to us.

1 Information

2 Occupants

3 Proposed Pet(s)

4 Vehicle(s)

5 Employment

6 Income

7 Financial Information

8 Emergency & Reference Contacts

9 Questionnaire & Autorization

Name*
Prefix First Last Suffix
Social Security Number*
Date of Birth*
MM
DD
YYYY
Marital Status*
- Single
- Married
- Divorced
Drivers License Number*
Drivers License State*
Phone (Cell or Home)*
Phone (Home or Work)
Email*
Present Home Address*
Street Address Address Line 2 City State ZIP Code
Length of Time at Present Home*
Landlord Name*
First Last
Landord Phone*
Reason for Leaving*
Amount of Rent*
Is your present rent up to date?*
- Yes
- No
Previous Home Address*
Street Address Address Line 2 City State ZIP Code
Length of Time at Previous Home*
Previous Landlord Name*
First Last
Reason for Leaving*
Amount of Rent*
Was your rent up to date?*
- Yes
- No
Next Previous Home Address
Street Address Address Line 2 City State ZIP Code
Length of Time at Previous Home
Landlord Phone
Previous Landlord Name
First Last
Reason for Leaving
Amount of Rent
Was your rent up to date?
- Yes
- No

Proposed Occupants
Proposed Occupant #1*
First Last
Occupant #1 Relationship, Occupation & Age*
Proposed Occupant #2
First Last
Occupant #2 Relationship, Occupation & Age
Proposed Occupant #3
First Last
Occupant #3 Relationship, Occupation & Age

Proposed Pets
Pet Name
Type / Breed
Pet Age
- Indoor
- Outdoor
Pet Name
Type / Breed
Pet Age
- Indoor
- Outdoor
Pet Name
Type / Breed
Pet Age
- Indoor
- Outdoor

Vehicle(s) Information
Year
Make
Model
Color
Plate Number
State
Vehicle #2 Year
Vehicle #2 Make
Vehicle #2 Model
Vehicle #2 Color
Vehicle #2 Plate Number
Vehicle #2 State

Employment
Current Employer*
Occupation*
Hours / Week*
Supervisor*
Employer Phone and Extension*
Years Employed*
Past Employer*
Occupation*
Hours / Week*
Supervisor*
Employer Phone and Extension*
Years Employed*

Credit Card / Financial Information
Car Loan
Balance Owed
Monthly Payment
Creditor's Phone
Credit Card Company
Balance Owed
Monthly Payment
Creditor's Phone
Child Support / Other Credit Owed
Balance Owed
Creditor's Phone
Monthly Payment
Bank Account & Name of Bank
Balance
Monthly Payment
Account Number

Emergency / Personal Reference Information
Emergency Contact Name*
First Last
Emergency Contact Address*
Street Address Address Line 2 City State ZIP Code
Relation*
Emergency Contact Name
First Last
Emergency Contact Address
Street Address Address Line 2 City State ZIP Code
Emergency Contact Phone
Relation
Personal Reference*
Street Address Address Line 2 City State ZIP Code
Reference Phone*
Relation*
Personal Reference #2
Street Address Address Line 2 City State ZIP Code
Reference Phone #2
Relation

Country Manor Apartments: Submit a rental application

Submit an Application

Country Manor Apartments Rental Application

Proposed Occupants

Proposed Pets

Vehicle(s) Information

Employment

Income

Credit Card / Financial Information

Emergency / Personal Reference Information

Applicant Questionnaire / Authorization