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Rock Bridge Meadows Apartments


Please complete this application with all applicable details. If you are accepted as a tenant, this application will become part of the lease. If more than one tenant (other than minor children) will be occupying a unit, each must complete a separate application. By signing below, you represent that the information provided is true and complete, you authorize lessor to contact third parties to verify the information given, and you specifically authorize lessor to check on your credit through a credit-reporting agency. A non-refundable application fee of $10.00 must be paid to cover the lessors expenses in verifying the information you provide. If a space provided is too small, continue your answer on a separate sheet of paper and attach it to this application. Desired Move-In Date: Name: Social Security No.:
How long?

__ Male __ Female Drivers License No.:

How long?

Birth date: D/L Issuing State:

__ Single __ Married __ Separated _____________ Divorced ____________ Email: ____________________________________________________________ Pets: ____ Yes ____ No If Yes, describe in detail including weight, breed:

Current home phone: Cell phone number:

LIST ALL PEOPLE WHO WILL RESIDE IN THE UNIT IN ADDITION TO THE APPLICANT Names Gender __ Male __ Female __ Male __ Female __ Male __ Female Name & address of Applicants Employer: (2 years information) Work phone number: Age Relationship to Applicant



Payroll frequency:

How long employed:

Present residence address: __ Rent __ Own

How long at present residence:

If currently renting, name & phone number of landlord:

In this block list all other residence addresses for the past 5 years, along with the name, address and phone number of each landlord if you rented.

State the name(s), address and telephone number of your parent(s) or guardian(s). This should be someone who would know on a permanent basis how to contact you:

Have you ever broken a lease agreement by moving before it expired? __ Yes __ No If yes, provide details:

Have you ever been evicted from any type of housing or sued for any reason by a former landlord? __ Yes __ No If Yes, provide details:

Have you ever been arrested, charged, convicted, pled guilty or placed on probation for any crimes or violations of city ordinances (other than non-substance-related traffic offenses)? __ Yes __ No If Yes, list below the date, type of offense, court and city or county in which charged, disposition of case, and any comments you deem relevant.

How many vehicles would you keep at the leased premises? ______ For each vehicle, state the year, model, manufacturer, license plate number, and state of licensure. Also indicate if any vehicle has body damage, defective paint or leaking fluids.

Bank reference Name of Bank:


Account No.:

In this block list stores and credit card companies with which you have had credit in the past five years. Include the company name, address, telephone number and account number.

Student Information: School


Student Number:

In this block list two persons to notify in case of emergency. Include their name, address, telephone numbers and email.

This Application does not obligate Owner and/or Owners Representative to execute a lease or deliver possession of the proposed premises. Applicant represents and warrants that all of the above statements are true and complete and hereafter authorizes verification of the above information, references, credit sources and all other information both public and private. Applicant acknowledges that the inclusion of any false information herein shall constitute grounds for rejection of this application, termination of any rental agreement and right of occupancy and/or forfeit of all deposits. To Whom It May Concern: Please be advised that the undersigned have made application to Rock Bridge Meadows Apartments requesting lease agreement. Therefore the undersigned applicant hereby authorizes you to make a consumer report and/or disclosure to Rock Bridge Meadows Apartments or any Agent or Employee thereof, including but not limited to, indebtedness, deposit balance, employment or rental history. A photograph, carbon copy or facsimile bearing a copy of signature(s) may be deemed equivalent of the original hereof and may be used as a duplicate original.

Date of Application:

Applicants Signature:

By signing here, I specifically authorize the lessor to obtain a credit check on me through a credit reporting agency. Date of Witness: Signature of Witness:

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