By filling out the form below you agree that you have read and will comply with our RENTAL TERMS
Name:
Who referred you to us or how did you hear about us?
Unit Applying For:*

LIST OF PERSONS WHO WILL OCCUPY THAT APARTMENT

Occupant 1:
E-mail:*
Cell Phone:
-
Phone:
-
Present Address:
Previous Address:
Occupant 1 Date Of Birth:
Relationship:
Gender:
SSN: *
D/L#:
State of Driver's License:

PRESENT LANDLORD/MORTGAGE COMPANY

Present Landlord:
Present Landlord's Phone:
-
Address:
How long?
Why are you leaving?
Previous Landlord?
Landlord Address
Landlord's Phone:
-
Present Employer:
Address:
Position:
Nature of Business:
How long employed?
Phone:
-
Income?
Name of Previous Employer:
Address of Previous Employer:

OTHER INCOME

Source:
Amount:
Source:
Amount:

BANK ACCOUNTS

Bank:
Checking/Savings Amount:
Bank:
Checking/Savings Amount:

´╗┐CREDIT REFERENCES

Reference 1:
Amount Owed:
Monthly Payment:
Reference 2:
Amount Owed:
Monthly Payment:

VEHICLE INFORMATION

Cell Phone:
-
Make, Model, Color:
Year:
License Plate #:
State of License Plate:
Occupant 2
Occupant 2:
E-mail: *
Phone:
-
Present Address:
Previous Address:
Occupant 2 Date Of Birth:
Relationship:
Gender:
SSN:*
D/L#:
State of Driver's License:
PRESENT LANDLORD/MORTGAGE COMPANY
Present Landlord:
Address:
Name:
How long?
Why are you leaving?
Previous Landlord?
Landlord Address:
Landlord's Phone:
-
Present Employer:
Address:
Position:
Nature of Business:
How long employed?
Phone:
-
Income?
Name of Previous Employer:
Address of Previous Employer:
OTHER INCOME
Source:
Amount:
Source:
Amount:
BANK ACCOUNTS
Bank:
Checking/Savings Amount:
Bank:
Checking/Savings Amount:
CREDIT REFERENCES
Reference 1:
Amount Owed:
License Plate #:
State of License Plate:
Year:
Monthly Payment:
Reference 2:
Amount Owed:
Monthly Payment:
VEHICLE INFORMATION
Make, Model, Color:
Year:
State of Vehicle License Plate:
Occupant 3
Occupant 3: (Minor)
Relationship:
Gender:
Occupant 4
Occupant 4: (Minor)
Relationship:
Gender:
Occupant 5
Occupant 5: (Minor)
Relationship:
Gender:
OTHER INFORMATION
Have you or your spouse ever broken a lease or been evicted from an apartment?
If yes, please explain:
Have you or your spouse ever been sued for non-payment of rent or damages to property?
If yes, please explain:
Desired Date of Occupancy:
Emergency Contact Name:
Relationship:
Address:
Phone:
-
There is a $40 application fee plus a $1.50 processing fee (Fee is non-refundable) per occupant to be paid via debit or credit card:
$40 Per Occupant: (plus a $1.50 processing fee)*
RELEASE OF INFORMATION

I represent that I am applying to rent a residential premise from Southern Breeze LLC. It is important that my prospective landlord or property manager be provided with information regarding my tenancy with current or former landlord or property managers, credit history, employment history, and any criminal records. Western Reporting and Southern Breeze LLC will be providing said information. I, the above named, give Western Reporting and Southern Breeze LLC permission to communicate with my current and former landlord or property manager for the purpose of discussing any and all of the facts and circumstances of my current or former tenancy, as well as the other information listed on my application. There are no limitations or restrictions regarding what may be discussed or revealed to Southern Breeze LLC and Western Reporting. I also give my permission to communicate with my current employer(s) and/or supervisor(s) for the purpose of verifying the employment information listed on my application. I am aware that a credit history, eviction search and/or criminal background check will be done in conjunction with my application. I hereby hold Southern Breeze LLC and Western Reporting free and harmless of any liability for providing written or verbal information and/or discussing the quality of my tenancy with current and former landlords, property managers, supervisors, or employers. I understand that I may have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigation. By submitting this application, I hereby consent to the delivery of all notices or disclosures required by law via any medium so chosen by the community or Western Reporting, including but not limited to email or other electronic transmission. Notices shall be deemed received upon being sent.

Occupant 1 Electronic Signature:
*
Occupant 2 Electronic Signature:*
*Minimum application processing time is 48 hours