Application to Rent

Number of Vehicles? *

Former address #2: *

Current Employer: Dates/salary/contact person & number-Skip if not employed

Date of Birth *

Email: *

Number of adults residing in the unit full or part time.. *

Previous Employer: Dates/salary/contact person & number

Suite Applying for: *

Previous Employer: Dates/salary/contact person & number

Emergency contact person *

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. *

Rental History *

Employment Status / Student Status *

Current address:

Upload Employment Proposal Letter if starting new job.

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

Former address #1: *

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

Number of children residing in the unit full or part time. *

Cell phone: *

Name: *

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

Does anyone smoke? *

Choose *

Social Security Number: