Desired Address and Unit or type:

Date of Application: Desired Move-In Date:

PERSONAL INFORMATION

First Name: MI: Last Name:

S.S. #: Date of Birth: Place of Birth:

Telephone Numbers: Home: Mobile:

Marital Status: SingleMarriedSeparatedDivorced

Cohabitant: Date of Birth:

S.S #: Mobile Phone #:

Name and ages of possible occupants:

Email Address:

Would like to receive a copy of this application? YesNo

RESIDENCE HISTORY

Present Address:

Date There: From:

Current Rent: What Utilities You Pay:

Landlord: Landlord Phone #:

Previous Address:

Date There: From: To:

Has an eviction/forcible detainer ever been filed against you/cohabitant? YesNo

If Yes, then explain:

Is there an unsatisfied judgement against you/cohabitant? YesNo

If Yes, then explain:

Are any child support payments being deducted from your paycheck? YesNo

Do you/cohabitant have any pets? YesNo

If So what kind?

PRIMARY APPLICANTS EMPLOYMENT HISTORY/INCOME SOURCE

Employed By: Supervisor:

Address: Phone #:

Start Date: Position:

Income: Per:

Past Employer: Supervisor:

Address: Phone #:

Start Date: End Date:

Position:

Income: Per:

Other Income & How much (ie: Child Support, Alimony, SSI, etc.):

COHABITANT'S EMPLOYMENT

Employed By: Supervisor:

Address: Phone #:

Start Date: Position:

Income: Per:

Past Employer: Supervisor:

Address: Phone #:

Start Date: End Date:

Position:

Income: Per:

Other Income & How much (ie: Child Support, Alimony, SSI, etc.):

COHABITANT'S RESIDENCE HISTORY

Present Address (Including City & Zip Code):

Current Rent: What utilities do you pay?:

Landlord: Phone #:

Date There: From: To:

Email:

REFERENCES (PERSONAL & BUSINESS)

1st Personal Reference: Phone #:

2nd Personal Reference: Phone #:

Credit Card(s): Account #(s):

Oustanding Loan(s): Account #(s):

Bank / Branch:

Checking Account #: Savings Account #:

MISCELLANEOUS

Automobile Information:

Make: Model: Year: Color:

License Plate #: Serial #:

Lienholder: Lienholder Phone #:

EMERGENCY CONTACT

In Case of Emergency Notify: Phone #:

Relationship: Address:

This applicant acknowledges that the $45 non-refundable cash or money order application fee (Per Person) shall be used for a background check from the credit bureau, references, and other investigative agencies that Square Management deems necessary. This application is valid for 30 days only.

I undersigned, hold the above information to be true to the best of my acknowledge. I understand that giving false information is justification for forfeiture of the application fee.

By selecting "YES" in the box, I acknowledge that I have read and understand this agreement in its entirety. NoYes

Applicant 1:

Applicant 2: