Name____________________________________________________ Date of Birth________________
Present Address____________________________________________________________________
Length of Residence________ To Whom Rent Paid_____________________ Phone______________
Present Home Phone#________________________ Business Phone #_______________________
Soc. Sec. #____________________________ Driver’s License #___________________________
Name of Spouse or Co-Applicants Name___________________________________________________
Name and Address of Your Bank_________________________________________________________
Checking #______________________________Savings#______________________
Name and Address of your Employer ___________________________________________________
Annual Income _____________________
Occupation _______________________________________
Length Employed ____________ Supervisor____________________ Phone ___________________
List Three Credit References
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Person to Notify in Emergency____________________________________
(Name, Phone No., Address, City, State and Zip Code)
The Applicant hereby deposit’s $25.00 as earnest money to be refunded if this application is not accepted. Upon acceptance of this application, this deposit shall be applied toward the security deposit.
The Applicant agrees, upon acceptance of this application, to pay the balance of the security deposit and the remainder of the first months rent. If after acceptance of this application, the applicant fails or refuses to execute the lease, or to pay the security deposit and the remaining first month’s rent, then the deposit may be retained by the Landlord or his agent as liquidated damages in payment of the Landlord’s time and effort in processing this application.
________________________________________(Resident)
________________________________________(Manager)
Sign and mail to Grosvenor Arms, 333 E. 16th Ave. #206, Denver, CO 80203 with $25 Fee.