Medina, Ohio 44256 Move In Application Down Payment Available Down Payment Less than $3000 $3000 - 5000 $5000 - 8000 More than $8000 Timeframe Timeframe Now 15 - 30 days 30 - 60 days 60 - 90 days More than 90 days Move In timeframe * Timeframe Less than 30 days 30 - 60 days 60 - 90 days 3 - 6 months More than 6 months Applicant Basic Information Name (First Middle Last) * Suffix I II III IV V PhD Jr Sr Home Address * Apt City, State and Zip State Alaska Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Main Phone Type Work Home Mobile Other Timeframe 9AM-12PM 12PM-3PM 3PM-6PM 6PM-9PM Alt. Phone Type Work Home Mobile Other Timeframe 9AM-12PM 12PM-3PM 3PM-6PM 6PM-9PM Email * Date Of Birth * Soc. Sec. # Applicant Employment History Current Employer Address Ste. City, State and Zip * State Alaska Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Current Position * Gross Monthly Income * Length of Employment * Length of Employment 0-1 year 1-3 years 3-5 years 5-10 years 10-20 years 20-40 years Contact Phone Number Previous Employer Name and Time Frame Co-Applicant Basic Information Co-Applicant Full Name Main Phone Type Work Home Mobile Other Best Time to Call Timeframe 9AM-12PM 12PM-3PM 3PM-6PM 6PM-9PM Alt. Phone Type Work Home Mobile Other Best Time to Call Timeframe 9AM-12PM 12PM-3PM 3PM-6PM 6PM-9PM Email Address Date Of Birth Soc. Sec. # Co-Applicant Employment History Address Ste Number City, State and Zip Contact Phone Number Co App Monthly Income * Co-App Time Frame * Please select a co-app time frame 0-1 Year 1-3 Years 3-5 Years 5-10 Years 10-20 Years 20-40 Years Credit History How would you rate your credit? * Credit Rating Excellent Good Fair Poor Are you pre-qualified for a loan? * Yes No Good Credit Credit Card Payment * Installment Loan Payment * Car Payment * Bad Credit Bankruptcy? * Please select a bankruptcy None Chapter 7 Chapter 13 Foreclosure? * Yes No Back Taxes? * Yes No Back Child Support? * Yes No Judgement Amount? * Landlord or Mortgage Information Name and Phone * Payment Amount * Move-In Date * Move-Out Date * Previous Name and Phone Move In Date State Reason for Moving * Additional Information Personal Reference One - Name and Phone * Emergency Contact - Name and Phone * Phone * Vehicles Parked On Premises * List pets you have. * How many people live in the house? * Please select a members in household 1 2 3 4 5 6 7 8 9 Criminal & Credit History been convicted of a felony? * Yes No been evicted? * Yes No broken a lease * Yes No If yes to any, please Explain
