GASLIGHT
APARTMENTS
69-71Hamilton Street, Saratoga Springs, New York 12866
Phone (518) 587-5220 'Fax (518) 587-1317
skidmore @burnsmgmt. com
Return this application to the rental
ffice at:
86 Circular Street, Saratoga Springs, New York 12866
Today's Date:
PERSONAL INFORMATION
Date of Birlh
Applicant's Full Name
Cell Phone Number
Email Address
Phone Number
Social Security #
RESIDENCE HISTORY
Current Address
State
City
Street
ZiP
Length of Time at Present Address (Dates)
Phone #
Landlord or Morlgage Holder
Reason for Moving
Amount of Monthly Rent,Mortgage $
Previous Address
State
City
Street
ZiP
Length of Time at Previous Address (Dates)
Phone #
Landlord or Mortgage Holder
Reason for
Amount of Monthly RentMortgage $
Moring-
EMPLOYMENT/INCOME INFORMATION
How Long? (dates)
Applicant's Employer
Employer's Address
State
City
Street
Salary
Position Held
S
Phone Number
Phone Number
Supervisor
PAYCHECK STUB OR OFFER LETTER REQUIRED
PROOF'OF INCOME REQUIRED F'OR ANYONE WITHOUT EMPLOYMENT
OTHER RESIDENTS TO OCCUPY APARTMENT
Name
Relationship
Date of Birth
Name
Relationship
Date of Birlh
Name
Relationship
Date of Birth
ZiP
BANKING REFBRENCES
Bank
Branch
Checking Account Number
Savings Account Number
OTHER INFORMATION
Have you ever declared bankruptcy?
Have you ever been convicted ofa felony?
Have you ever been evicted?
No il Yes L'
No fl Yes Ll
Notr YesE
Applicant Driver's License Number
Make/Model
Year
Color
Plate #
State
MOTORCYCLES & LARGE COMMERCIAL VEHICLES ARE PROHIBITET)
In Case of Emergency, Contact
Relationship
Address
Phone Number
Street
City
zip
State
NO PETS ALLOWED
READ CAREFULLY BBFORE SIGNING
I hereby authorize Burns Management to obtain consumer reports and any other information it deems
necessary, for the
purpose of evaluating my application. I understand that such information may
include, but is not limited to credit history,
rental history, civil and criminal information, employment/income verification and/or
any other necessary information. I
understand that subsequent consumer reports may be obtained and utilized under this
authorization in connection with an
update, renewal, extension or collection with respect to or in connection with, the
rental or lease of a residence for which
application was made' I agree to hold the above named company and procurer or furnisher
of information, from any liability
what-so-ever in the use, procurement, or furnishing of such information. I understand
that any false
statements/representations made in this application may be used as termination of
applicationTl"ur".
There is a $35 non-refundable application fee for each applicant and a $ 100 deposit to
secure the apartment lvhich will be
returned only in the event that the application is not approved.
Applicant Signature
Date
FOR OFFICE USE ONLY
Move in Date
nPresent Landlord
IPrevious Landlord
nEmployment
trCredit
trBank
Date Application Received
Received Bv
Advance Deposits:
DATE
DESCRIPTION
lOther
THIS APPLICATION: nAPPRovED INOT APPROVED
BY
SECURITY DEPOSIT
AMOUNT