Arbor Place
200 Arbor Place Court
New Albany, IN 47122
812 944-0900
812 944-1352 fax
"One and Two Bedroom Luxury Apartment Homes"

RENTAL APPLICATION
Please Note: This will NOT be processed until a $35.00 non-refundable application fee and a copy of your drivers license is received at our office.
Printable version

PERSONAL INFORMATION

Do not press the ''Enter'' key until you are ready to submit this form.

Applicant's Full Name:
Social Security No.:
Date of Birth (mm/dd/yyyy):
Marital Status:

Others to Reside in Apartment:
Name:

Soc. Sec. No.:

Relationship:

Date of Birth (mm/dd/yyyy):
Name:

Soc. Sec. No.:

Relationship:

Date of Birth (mm/dd/yyyy):
Name:

Soc. Sec. No.:

Relationship:

Date of Birth (mm/dd/yyyy):
Name:

Soc. Sec. No.:

Relationship:

Date of Birth (mm/dd/yyyy):
Name:

Soc. Sec. No.:

Relationship:

Date of Birth (mm/dd/yyyy):
Name:

Soc. Sec. No.:

Relationship:

Date of Birth (mm/dd/yyyy):

Have you ever been evicted?
Have you ever declared bankruptcy?

RESIDENCE HISTORY

Present Address
Street Address:
Apt No.:
City:
State:
Zip:
Phone:
Rent or Own: Dates (mm/dd/yyyy):
To (mm/dd/yyyy):
Monthly Payment:
Landlord/Lender:
Street Address:
City:
State:
Phone:

Previous Address
Street Address:
Apt No.:
City:
State:
Zip:
Phone:
Rent or Own: Dates (mm/dd/yyyy):
To (mm/dd/yyyy):
Monthly Payment:
Landlord/Lender:
Street Address:
City:
State:
Phone:

EMPLOYMENT INFORMATION

Current Employer
Name:
Street Address:
City:
State:
Zip:
Phone:
Employment Dates (mm/dd/yyyy):
To (mm/dd/yyyy):
Position:
Supervisor:
Salary:
Per:

Previous Employer
Name:
Street Address:
City:
State:
Zip:
Phone:
Employment Dates (mm/dd/yyyy):
To (mm/dd/yyyy):
Position:
Supervisor:
Salary:
Per:

Spouse's Employer
Name:
Street Address:
City:
State:
Zip:
Phone:
Employment Dates (mm/dd/yyyy):
To (mm/dd/yyyy):
Position:
Supervisor:
Salary:
Per:

BANKING AND CREDIT REFERENCES

Bank:
Branch:
Checking Account No.:
Savings Account No.:
Credit Reference:
Account Number:
Entire Address:
Credit Reference:
Account Number:
Entire Address:
Credit Reference:
Account Number:
Entire Address:
Credit Reference:
Account Number:
Entire Address:
Credit Reference:
Account Number:
Entire Address:
Credit Reference:
Account Number:
Entire Address:
Other Reference:
Entire Address:

OTHER INFORMATION

Automobiles
Number of Automobiles (Including Company Cars):
Driver's License No.:
Make:
Year:
Color:
Tag No.:
State:
Make:
Year:
Color:
Tag No.:
State:
Make:
Year:
Color:
Tag No.:
State:
Relatives/Emergency Contact (Not Residing With You)
(1) Name:
Relationship:
Phone:
Street Address:
City:
State:
Zip:
(2) Name:
Relationship:
Phone:
Street Address:
City:
State:
Zip:

By submitting this form, I hereby make application for an apartment at Arbor Place Apts. and certify that all the information I have provided is correct and complete. I authorize the management of Arbor Place Apts. to contact any references and verify the information listed on this application. This includes obtaining a consumer credit and/or public records report. I also realize that the electronic transmission of this information in this form is not secure, and thus it is technically possible (though not likely) for others to ''eavesdrop'' on my information. I will not hold Arbor Place Apartments, their webmasters, their webhosts, and/or any other associated parties responsible if others do ''eavesdrop'' on my information.

Arboretum 1.5 is © 1999, 2001 Daniel Plummer.

http://www.ArborPlaceApartments.net