RESIDENTIAL LEASE APPLICATION

NAME OF APPLICANT (Leaseholder, Occupant or Guarantor)

IN CASE OF EMERGENCY - NOTIFY

Describe (include weight)

PRESENT ADDRESS

$

LANDLORD

PREVIOUS ADDRESS

$

PREVIOUS LANDLORD

EMPLOYMENT



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BANKING INFO

Note: Letter from employer on company letterhead verifying income is required. If self employed, letter from CPA verifying income is required.

OTHER INCOME

REFERENCES

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How did you find this apartment?

The Landlord will in no event be bound, nor will possession be given, unless and until a lease executed by the landlord has been delivered to the tenant. The applicant and his/her references must be satisfactory to the Landlord.

A.D. Real Estate Inc. shall in no event be liable as respects any matter concerning this application, or concerning any act of the Landlord or failure to act on the part of the Landlord in connection with this application, or in connection with any lease or leases contemplated herein. No representations or agreements by agents, brokers or others are binding on the Landlord unless included in the executed lease.

I hereby warrant that all my representations set forth herein are true. I recognize that the truth of the information contained herein is essential. I further represent that I am not renting a room or an apartment under any other name, nor have I ever been dispossessed from any apartment, nor am I now being dispossessed and that I am over 18 years of age.

I have been advised that I have the right to make a written request, directed to the appropriate credit reporting agency, within a reasonable time for a complete and accurate disclosure of the nature and scope of any credit investigation. I understand that upon submission, this application and all documents become the property of the Landlord of Agent, and will not be returned to me under any circumstances.

I authorize the verification of the above referenced information and its release to Landlord and its agents connected with the lease contemplated herein. I authorize A.D. Real Estate Inc. and Sanjeonics, and their agents to obtain a consumer credit report on me and to verify any information on this application with regard to my employment history current and prior tenancies and all other information, which the Landlord deems pertinent to my obtaining residency. I will present any other information required by the Landlord in connection with the lease contemplated herein.

I understand that the $100.00 credit checking fee is non refundable.