Emerald Gardens

You can now submit your application by choosing one of the two options:

	Fill out the form below OR
	Download this rental application and fill it out to apply for a rental at our apartments. Fax this form back to our office at 412-921-8753 You need Adobe Acrobat Reader to view and print this document. If you do not have Acrobat Reader Click here!

Applicant Name

*Last:

*First:

MI:

*Soc. Sec. #

Marital Status:

*Date of Birth:

*Email Address:

Drivers Lic #

State Issued:

*Home Phone:

Cell phone:

Co-Applicant Name

Last:

First:

MI:

Soc. Sec. #

Other Occupants:

Birth Date:

SS#:

Relationship:

Please provide 5 years of continuous history:

*Complete current address:

Mortgage Rent $:

Dates from: To:

Landlord/Mortgage company name:

Landlord/Mortgage company address:

Landlord/Mortgage company phone #:

What is your reason for moving?

Previous address:

Mortgage Rent $:

Dates from: To:

EMPLOYMENT: Please provide 2 years of continuous history

Please check off all applicable:

Employed full time Employed part time Retired Self employed Unemployed

Current Employer:

Position:

Address:

Phone Number:

Dates from: To:

Current Salary $: Per hour Per Year Per pay

Pay Cycle: Weekly Bi Weekly Monthly

Supervisor's Name:

Supervisor's Phone Number:

Previous Employer :

Position:

Address:

Phone Number:

Dates from: To:

Previous Salary $: Per hour Per Year Per pay

Supervisor's Name:

Supervisor's Phone Number:

In case of emergency, notify:

Name: Phone: Relationship:

In the event of serious illness or death of resident(s), the above person may may not enter, remove and/or store all contents found in dwelling or mailbox.

Credit References:

Name of Institution: Phone:

Other loans:

Do you have any of the following credit cards:
Visa Master card Discover Card American Express
Other:

Have you ever filed bankruptcy? yes no
Discharge date and case #:

Have you ever been evicted? yes no
When?

Have you ever willfully or intentionally refused to pay rent when due?
yes no

Vehicle Information:

How many vehicles will you keep at this address?

Make	Model	Year	Color	License # & State

Pet Information:

*Do you own a pet ? yes no
Dog Cat Bird Other:

Note: All applicants owning a pet(s) must have landlords prior written approval, complete a pet addendum to the lease, pay an additional refundable deposit together with an additional monthly rental fee.

The Management relies on the information provided above to be complete and accurate in order for the application to be processed in a timely manner. Any false statements, misrepresentations, inaccurate information or failure to supply the information requested may serve as a rejection of your application. By signing this application, you are authorizing the use of any credit reporting/screening agencies to verify credit, validate the accuracy of the information reported. Further, your signature authorizes the management and the credit reporting/screening agencies to later exchange credit information.

I/We hereby deposit $35.00, which is a non-refundable payment for a credit and processing charge, receipt of which acknowledged by Management, such sum is not a rental payment. In the event this application is disapproved, this sum will be retained by Management to cover the cost of processing the application as furnished by applicant. This application must be signed before Management will process it. (Applicant’s Initials )

(Optional)
I/We hereby deposit $ , which is a holding fee that will be applied to my security deposit. I understand that in the event I/We cancel this application, the Management will retain our holding fee. I/We acknowledge the Landlord will suffer damages as a result of the processing of this application and holding a specified unit for a specified move in date. The deposit will be returned if this application in not approved, providing all questions are answered correctly and truthfully. (Applicant’s Initials )

The above information, to the best of my knowledge is true and correct.

I AUTHORIZE AN INVESTIGATION OF MY CREDIT, A CRIMINAL BACKROUND CHECK, TENANT HISTORY, BANKING AND EMPLOYMENT FOR THE PURPOSES OF RENTING AN APARTMENT FROM THIS OWNER/MANAGER

Name: Date:

Credit Card Information:

Card Number:

(We currently only accept Visa or Mastercard)

Exp. Month:

Exp. Year:

Comments:

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