Application to Rent

Does anyone have any animals or intend to get any animals during the lease term? *

Current address:

Date of Birth *

Rental History *

Previous Employer: Dates/salary/contact person & number

Former address #2: *

Current Employer: Dates/salary/contact person & number

Does anyone smoke? *

Number of adults residing in the unit. *

Email: *

Name: *

Suite Applying for: *

E Signature: The ESIGN Act is a federal law passed in 2000. It grants legal recognition to electronic signatures and records if all parties to a contract choose to use electronic documents and to sign them electronically. ... No contract, signature, or record shall be denied legal effect solely because it is in electronic form. *

Student? *

I warrant that the information supplied is true and correct, and that I am at least 18 years of age. I further authorized the owner/manager to contact my references . I give my previous landlord and employment references permission to release my personal information to Diemer Properties, LLC and Clock Tower Square. Owner warrants that any verification/s are for the purpose of entering into a Rental/Lease Agreement, and further warrants that any information derived from TRW credit aka Smart Move/ criminal reports or other sources will be kept confidential and not revealed to any other outside party. If credit report is necessary there is a $40.00 charge. ( You will be notified in advance if credit report is required). I agree to these terms. * *

I understand

Social Security Number:

Choose *

Cell phone: *

Number of Vehicles?

Number of children residing in the unit. *

Emergency contact person *

Former address #1: *

Picture of Licence/Passport or other Valid Picture ID: Upload file *

Previous Employer: Dates/salary/contact person & number