1234 E.

Elm Springfield, MO 65802

417-869-5421 Fax 417-869-5509
[email protected]

Rental Application
Required Application Fee $ ___________
Occupancy Date Desired ________________________
Rental Price Range $____________________________
Type and size desired _________________________________________________________________________
Rental Address shown: ________________________________________________________________________
How did you find out about our property? _________________________________________________________

Applicant’s Personal Information

First Name: ___________________________ Middle: ______ Last: ___________________________________
Any other names you’ve used in the past: __________________________________________________________
Driver’s license / ID number / state: ______________________________________________________________
Social Security # : ____________________________________________ Date of Birth: ____________________
Cell phone # : ________________________________________________________________________________
E-mail Address: ______________________________________________________________________________
All Additional Occupants listed below and relationship to applicant:
____________________________________________________________________________________________
____________________________________________________________________________________________

Residence History
Present street address: __________________________________________________________________________
City: _____________________________ State: ___________________ Zip code: _________________________
Dates lived at this address: __________________________________ Own ______ Rent ______ Occupy ______
Current Phone: ________________________________________________________________________________
How many pets do you have?: __________ Type of pets: ______________________________________________
Name of present Landlord / Manager: ______________________________________________________________
Landlords phone #: __________________________________ Monthly rent: $_____________________________
Are you paid in full? ____________________ Reason for moving: ______________________________________
_____________________________________________________________________________________________
Have you given notice that your moving? ___________________________________________________________
Number of late payments in last year: ______________________________________________________________
Deposit amount currently held by Landlord: $________________________________________________________
What is one feature or amenity that you like at your current home? _______________________________________
Previous residence address: ______________________________________________________________________
Previous Landlord: _____________________________________________________________________________
Previous Landlord’s phone: ______________________________________________________________________
Dates lived at this residence: _____________________________________________________________________
Reason for moving: ____________________________________________________________________________
Was your full security deposit returned: ____________________________________________________________
Number of late payments:___________ Monthly rent $_______________________________________________
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 Income History
Student: ______ Retired: _______ Self-employed: _______ Unemployed: ____________ Other: _____________
Name of employer: _____________________________________________________________________________
Address of Employer: ___________________________________________________________________________
City: _____________________________ State: ___________________ Zip code: __________________________
Phone #: __________________________ Position: ___________________________________________________
Full time: _______________________ Part time (under 32 hours per week): _______________________________
Average weekly hours: _________________ How long at this place of employment? ________________________
Supervisor: ____________________________________________________________________________________
Please indicate weekly, bi-weekly, monthly average take home pay: _______________________________________
Additional or previous employment: ________________________________________________________________
Average weekly hours: _________________ How long at this place of employment? ________________________
City: _____________________________ State: ___________________ Zip code: __________________________
Phone #: __________________________ Position: ___________________________________________________
Supervisor: ____________________________________________________________________________________
Please indicate weekly, bi-weekly, monthly average take home pay: _______________________________________

Additional Income Source

If there is an additional, verifiable source of income you’d like considered for qualification, please list income
source and requested information below regarding each source ( e.g., Child support, Section 8 voucher, etc.).
Amount: ___________________ Income source: _____________________________________________
Contact person: _________________________________________________________________________
Phone #: ____________________ Relationship: ______________________________________________

Assets/Credits/Loans
Note: Only vehicles listed on application are authorized to be on premises.
Number of vehicles: ________________ Make/Model/Color/Year: ______________________________________
Plate #(s): __________________________ State: _____________________________________________________
Financed/Lease through: __________________________________________ Monthly payments: _______________
Credit Card or Loans
Creditor: _______________________________________________________________________________________
Phone #: ____________________________________ Account #: ________________________________________
Total amount owed: _____________________________Monthly payment: __________________________________
Are your payments current: _______________________
List approximate amounts of any other current monthly expenses:

Cable/Satellite TV: ______________ Medical payments: __________________ Health Insurance: ______________

Auto insurance: ________________ Tuition: ______________________ Renter’s insurance: __________________
Child care: ________________________ Other + amount: ______________________________________________

Bank Reference
Name of bank and branch: _________________________________________________________________________
City: ____________________ Checking or savings account #: ____________________________________________
Number of years account active: (checking): ____________________ (savings): ______________________________
Average monthly balance: (checking): _________________________ (savings): ______________________________

2
 Personal/Professional References
Personal reference or name of nearest living relative: _____________________________________________________
Street Address: ______________________________City: ________________ State: ________ Zip code: __________
Relationship: __________________________ How long: _________________________________________________
Phone # : ________________________________
Name of Doctor: _______________________________________ Phone #: ___________________________________
City: _____________________________ State: ___________________ Zip code: _____________________________
Professional reference(e.g., attorney): __________________________________ Phone #: _______________________
City: _____________________________ State: ___________________ Zip code: _____________________________
Have you ever:
Broken a lease? ____________________________________________________________________________________
Refused to pay rent for any reason? ____________________________________________________________________
Been evicted or asked to leave a rental unit? _____________________________________________________________
Filed for bankruptcy? _______________________________________________________________________________
Been convicted of a crime or felony? ___________________________________________________________________
Will you give us permission to do a criminal background check? _____________________________________________
Is there anything to prevent you from placing utilities in your name? __________________________________________
Do you know of any reason that may interrupt you from paying rent? __________________________________________
Preferred method of standard rental payments:
Check: __________________ Money order / cashiers check: ______________________________
Other methods of payment requiring an additional handling fee:
Credit Card: ___________________ Debit Card: ___________________ Electronic banking: _____________________
Payroll deduction: __________________________________________________________________________________
Would you like to buy a home within the next 2-3 years?: ___________________________________________________
Do you smoke?: ____________________________________________________________________________________
Do you own the following items?:
Liquid filled furniture?: ____________________ Plunger ______________ Lawn mower _________________________
Appliances (if so what kind): __________________________________________________________________________

Free Upgrade Bonus/Referral Bonus

Final note. Our company offers a free upgrade or referral reward for residents who recommend anyone to us who decides
to rent a separate unit from us. Please give the name and phone number of a friend, relative, or co-worker who may be
interested in renting. We will contact that person to inquire about applying for and renting one of our other homes or
apartments.
Name: __________________________________________________ Phone: ___________________________________
THANK YOU! Please note that a completed application requires submission of the following, which will be copied and
attached to this application:
____________ Driver’s license or picture ID
____________ Personal check (to verify bank)
____________ Two weeks of most current pay stubs or other proof of each income source listed

3
 Agreement and Authorization
The credit check fee is charged on all rental applications for the purpose of verifying the information furnished on this
application. By signing below, applicant hereby represents all information on this application is true and complete, and
hereby authorizes a credit check to be made, annual verification of information, and communication with all names/
references listed on this application for continual rental consideration or for collection purposes should that become
necessary. This fee is nonrefundable.

Applicant acknowledges this application will become part of the lease agreement, if approved. If any information is later
found to be incorrect or misleading, this will be sufficient reason for immediate eviction and loss of security deposit.

Applicant’s signature: ______________________________________________________________________________

Date: ________________________

Do Not Write Below This Line

Deposit: __________________________ Special: __________________________ Monthly Rent: _________________

Unit applying for: ___________________________________________________________________________
Term of Lease: _________________ Months total lease: ___________________________________________
Move-in Date: __________________ Lease expires: ____________________ Number of keys: ___________
Total number of occupants: _____________________ Separate pet fee: _______________________________
Utilities to be paid by tenants: _________________________________________________________________

4
 VERIFICATION OF APPLICATION INFORMATION

_____________
Date

Dear _______________

Thank you for taking the time to answer a few questions concerning a current or past tenant of yours.
This person is applying to lease one of our apartments.

Applicant: ________________________________________________
Address: _________________________________________________
_________________________________________________

Landlord/Company Name: ___________________________________

Person filling out this information: _____________________________

Title: ________________________

Rental Amount: ________________ Did tenant pay on-time? ____________

# of occupants: _________________ Any pets? _________________
How long did tenant live at the above address? ___________________
Did you have to give the tenant a notice to pay more than once? ______________
Did tenant keep the rental in good condition? _____________________________
Any damage? ___________ Explain: ___________________________________
Would you re-rent to this person:_______________________________________
Any other pertinent comments: ________________________________________
_________________________________________________________________

I (We) give authorization to release the information needed above. I (We) hereby release any person or firm
from any reliability for information pursuant to this authorization.

________________________________
Applicant Signature

___________________________________
Printed Name
Fax this information back to us at 417-869-5509
Thank you.

__________________________
Southwood Properties L.L.C.
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 VERIFICATION OF APPLICATION INFORMATION
_____________
Date

Dear _______________

Thank you for taking the time to answer a few questions concerning a current or past employee of yours.
This person is applying to lease one of our apartments.

Applicant: ________________________________________________
Address: _________________________________________________
_________________________________________________

Employer/Company Name: ___________________________________

Person filling out this information: _____________________________

Title: ________________________

How long has applicant worked there? ____________________ Full time? __________
Income: _____________ Paid weekly, biweekly or monthly? ______________________
Any other pertinent comments?______________________________________________
_______________________________________________________________________

I give authorization to release the information needed above. I hereby release any person or firm from any
reliability for information pursuant to this authorization.

________________________________
Applicant Signature

___________________________________
Printed Name

Fax this information back to us at 417-869-5509

Thank you.

__________________________
Southwood Properties L.L.C.

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 Southwood Properties L.L.C.
1234 E. Elm
Springfield, MO 65802

Addendum to Lease Security Deposit

The security deposit is used to secure and remove from the market an apartment or house with Southwood
Properties, LLC. The security deposit is refundable immediately upon funds clearing our bank if management
does not approve the Resident(s) to move-in. Acceptance of rental terms by one future Resident is deemed to
be acceptance for all the other Residents of the rental application. Approval to move-in to one of our residences
is deemed an “Approval to move-in” even if the applicants are accepted with conditions of extra deposit or
qualified co-signor(s). Once approval is given to move-in by management, Applicant(s) must decide within
three business days whether or not to accept the rental terms. Any security deposit left with Southwood
Properties, LLC beyond three ( 3) business days will not be refunded under any circumstances if Resident(s)
decides not to enter into a Rental Agreement with Southwood Properties, LLC.

_________________________________ __________________
Resident Date

_________________________________ __________________
Resident Date

_________________________________ __________________
Resident Date

_________________________________ __________________
Resident Date

_________________________________ __________________
Southwood Properties Management Date

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 Southwood Properties, LLC

PRIVACY NOTICE

Recently the United States Congress enacted federal legislation that deals in part with the protection or restriction from
disclosure of non-public information by financial institutions. Southwood Properties is obligated to provide you with this
notice to tell you how we may use non-public personal information that we obtain from you as a result of a credit
transaction you perform with Southwood Properties. For ease of reading we will refer to this non-public personal
information as “Private Information” in this notice. This notice applies to your Private Information while you are our
customer, as well as after our customer relationship is terminated.

Collection and Use of Private Information

We collect Private Information about you from a variety of sources, including the following:

• Information we receive from you, such as information on applications or other forms, which may include your
name, address, social security number, and income.
• Information, such as your account balance and payment history, about your transactions with Southwood
Properties, our affiliates, or others.
• Information we receive from customer reporting agencies, such as your credit history and creditworthiness.

Disclosure of Private Information

We may disclose Private Information (described above) under the following circumstances:

Among Affiliates

There are two special categories of Private Information. One is information about your history of dealing with us,
such as identification, account history and balance, and payment history (referred to as “Transaction Information”).
The second category is information received from other sources, including information typically found in a credit
report (referred to as “Third Party Information”). We may share all Private Information that consists of Transaction
Information with our affiliates. Our affiliates include other apartment complexes we manage, insurance companies,
and insurance service providers. We do this to provide you with information regarding the products or services our
affiliates and we offer. We do not share Third Party Information with our affiliates.

Protection of Information

We take a number of steps to protect your Private Information in a manner consistent with industry standards for property
management companies. We restrict access to the Private Information to authorized individuals who need to know this
information to provide service and products to you. We will review our safeguards from time to time and strive to
maintain them in a manner consistent with federal regulations, if any, that may be in effect from time to time.