Each Adult Applying For The Unit Must Complete A Separate Application. You May Submit Via Email or Fax to: 770-725-5328
CityBlock Properties Rental Application
Submit by Email
All information must be provided for processing. Application Fee $25.00
Print Form
Property Applying For:
Where did you hear about us:
Applicant Information:
Name:
Date of Birth:
Phone#
SSN:
Email:
Driver's Licese #:
Present Address:
State:
How Long At Current Address:
Landlord's Name:
Phone #:
Curretn Rent:
Fax #:
Reason For Moving:
Previous Address:
How Long at That Address
Landlord's Name:
Phone #:
Fax:
Reason For Moving:
Employment Information:
Current Employer:
Phone:
Fax:
Employer Address:
How long employed:
Part Time
Position:
Former Employer:
Full Time
Annual Income:
Phone:
Fax:
Address:
How long employed:
Part Time
Position:
Full Time
Annual Income:
Emergency Contact:
Address:
Name:
Relationship:
Email:
Phone:
Name:
Address:
Relationship:
Phone:
Email:
Credit References:
Checking Acct. (Last 4 Digits)
Bank Name:
Balance:
Checking Acct. (Last 4 Digits)
Bank Name:
Balance:
Credit Card Acct (Last 4 Digits)
Balance:
Monthly Payment
Credit Card Acct (Last 4 Digits)
Balance:
Monthly Payment
Other Credit Card Balances:
Foreclosure/Repossession:
Evictions:
Yes
No
Other Credit Card Payments:
Yes
No
Bankruptcy:
Yes
Car Payments:
No
Convictions Other Than Traffic Violation:
Yes
No
Please explain in the back if you have had any forclosures, repossessions, evictions or any convictions.
Other Information:
Pet Name:
Pet Type
Vehicle Make & Model:
Year:
Desired Date of occupancy:
Anticipated length of Stay:
Pet Weight:
Color:
Tag #:
Smoker
References:
Name:
Relationship:
Phone #
Name:
Relationship:
Phone #
Water bed owner
Explanations:
Please explain in the here if you have had any forclosures, repossessions, evictions or any convictions.
Conditions and Information:
Following must be completed before your application may be processed:
a. Submit completed application: Your physical signature is needed to process this application in a timely manner.
b. Submit all supporting documents: Last 2 Paycheck stubs & W2s. Parental guarantee is needed If not employed fulltime.
c. Pay application fee: Application fee is $25 (non-refundable). In a roommate situation, $25 per person.
d. Pay reservation fee: Reservation fee is one month's rent, if the monthly rent is $900, then reservation fee is $900.
The completing of this application by Tenant and the acceptance of this application by CityBlock Properties, INC. creates no
obligation of CityBlock Properties, INC. to approve this application. This application will be approved or rejected usually within five (5)
days of being submitted. However, there is no obligation of management to notify tenant unless the application is approved.
CityBlock Properties, INC. complies with all Federal and State laws regarding discrimination and does not discriminate based upon
age, sex, race, marital status, religion, national origin, or other prohibited classifications. CityBlock Properties, INC will keep your
personal information provided here confidential.
Radon Gas disclosure. Radon is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient
quantities, may present health risks to persons exposed to it over time. Levels of Radon that exceed federal and state guidelines have
been found in every State of the United States. Addition information regarding radon gas may be obtained from your County public
health unit, see Also http:// www.epa.gov/iag/radon/
By signing is form you are agreeing to the following conditions:
The undersigned expressly agrees that if this application is approved applicant herewith agrees to rent this property. Applicant
further agrees that if applicant is accepted by CityBlock Properties, INC. and then decides, for any reason, not to move into the
premises, then all monies paid herewith shall be retained as liquidated damages since other prospective tenants may have been
turned away and it may be necessary for CityBlock Properties, INC. to re-advertise the property and evaluate other applicants.
Processing of application shall be as timely as possible and the results may be delivered via telephone, fax or mail. Once approved,
applicant agrees to pay the balance of funds and complete the paperwork within 2 weeks or move in date whichever comes first,
otherwise management will assume that applicant has decided to forfeit the reservation/earnest money payment made herewith and
will begin re-marketing the property. If applicant is not approved, all monies given herewith, less application fee shall be returned to
applicant.
I declare that the application is complete, true and correct and I herewith give my permission for anyone contacted to release the
credit or personal information of the undersigned applicant to Management or their authorized agents, at any time, for the purposes
of entering into and continuing to offer or collect on any agreement and/or credit extended. I further authorize Management or their
Authorized Agents to verify the application information including but not limited to obtaining criminal records, contacting creditors,
present or former landlords, employers and personal references, whether listed or not, at the time of the application and at any time
in the future, with regard to any agreement entered into with Management. Any false information will constitute grounds for
rejection of this application, or Management may at any time immediately terminate any agreement entered into in reliance upon
misinformation given on this application.
CityBlock Properties, INC. 706-296-9546, 706-296-9547. WWW.CityBlock.Biz. [email protected]
Applicant:
Print Name:
Sign:
Date
Sign:
Date
Guarantor:
Print Name: