Please List All Other Residents To Occupy Premises


Credit References

Personal References (Use local when possible)

In Emergency Notify(required)

Answer "Yes" or "No"

Have you any collection, judgments, or even taken bankruptcy, had property foreclosed, or given deed in lieu thereof? YesNo

Have you every been evicted from an apartment or violated a rental agreement or contract? (required)YesNo

Have you ever been a defendant/ participant in a lawsuit? (required)YesNo

Do you intend to use the premises other than a residence? (required) YesNo

Have you ever been convicted of a felony? (required)YesNo

Have you ever been convicted of being a sex offender or designated as a sexual predator? (required)YesNo

Please explain any “yes” answers:

Pets? If yes, you must sign a lease amendment before move in. (Please Describe)YesNo

Number of Auto Owned by All Occupants

Please Describe Vehicles

Any Other VehiclesYesNo

Please Describe

Your Present and Prior Places of Residence (Please Go Back Five Years).

Please Give Your Employment Information

Spouse's Present Place of Employment


Applicant(s) represents that the statements above made are true and correct and hereby authorizes verification of references. Applicant(s) further understand that we are members of the Credit Bureau of Columbus, and will use their services in order to obtain any public record and credit history. The Applicant(s) makes Applications to rent a unit for the rental rate in effect at the date the specified unit is to be assigned hereafter, and upon approval of this application to sign a Lease in the form presented by the Landlord. It is understood by the Applicant(s) that this Application is preliminary only and involves no obligation of the Landlord or the Agents of the Landlord to approve this Application or to delivery occupancy of the unit. It is understood by the Applicant(s) that a copy of the Lease Agreement used by the Landlord will be furnished upon request. An APPLICATION FEE of $____ has been made by Applicant(s) to be held by the Landlord unit: (1) Applicant(s) execute a lease in a form presented by the Landlord; (2) this Application is not approved; or (3) Applicant(s) inform the Landlord in writing of his intention to withdraw said Application Fee prior to the date upon which the Landlord assigns a specific unit to the Applicant(s), and provides the landlord with his forwarding address. It is understood that upon execution of a lease in the form presented by the Landlord this Application Fee will be credited in full toward the Security Deposit requirement under said lease, and thereafter will be treated according to the terms applicable to said Security Deposit contained therein. It is further understood that in the event this Application is Rejected or if the Applicant(s) informs the Landlord, according to the requirements set out herein, of his intentions not to rent, the Application Fee will be returned in full to the Applicant(s). Anything to the contrary contained herein notwithstanding, IN NO EVENT WILL THE APPLICATION FEE BE RETURNED TO THE APPLICANT(S) ONCE A SPECIFIC RENTAL UNIT HAS BEEN ASSIGNED TO SAID APPLICANT(S) AND APPLICATION HAS BEEN APPROVED FOR OCCUPANCY.

I have read and agree to the terms and conditions stated above.YesNo


I hereby authorize you to release Schottenstein Real Estate Group, for verification purposes, information concerning:

  1. Employment, dates, title, income, hours worked, etc.
  2. Banking and Saving Account(s) of record.
  3. Mortgage loan rating, credit and criminal report; (opening date, high credit, payment amount, loan balance and payment record.).
  4. Rental history; (Term of Lease, Payment History, Problems and/or any derogatory information.).

Also, I hereby authorize utility service to be established in my name and agree to pay for such service.
This information is for the confidential use of Schottenstein Real Estate Group. A photographic or carbon copy of this Authorization, (being photographic or carbon copy of the signature(s) of the undersigned), may be deemed to be the equivalent of the original and may be used as a duplicate original.
Your prompt response and cooperation to this request is greatly appreciated.

I have read and agree to the terms and conditions stated above.YesNo