401 E. Springfield Ave. ^. Champaign, Il 61820 ^. 217-351-1800

rental application

***All spaces need filled in***

Date:                      Phone:  (Home)      (Work)        (Cell)             

e-mail address                    furnished      unfurnished             

address applying for                              

name                  birth date                    date to move in             

ss#                    dl#                   state            

marital status:    Single Married Divorced Widowed                                                                                             smoker      nonsmoker        

current address                  legal address                           

landlords name                landlords phone #   

landlords address                        

present rent $             date moved in               lease expires          

bank                 branch                      city          

checking acct#                      savings acct #   

employer                 phone#          

employer address                                    city           

position             date started                  hours per week          

salary             per             seasonal            permanent           temporary       

supervisors name                    dept.         

I (we) certify that all information herein is true and complete and give authorization for a

credit check, employment to be verified and prior landlords to be contacted.

typed name or electronic signature below and/ or transmittal of this completed form serves as acceptance of all terms and grants permission for all verifications to be performed. co-signer(s) and applicant(s) agree that original document with original signatures

will be sent (via usps, ups, or other) to management company within 24 hours of transmittal of this form. failure to do so may result in property being leased to others or forfeiture of deposit.

CO-SIGNER applicant's signature                                                                        date       

this application will not be processed until completed in full, signed, and accompanied with a full deposit.