Rental Application

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Note: Applicants musts be 19 years of age in the State of Nebraska

Persons Other Than Applicant to Occupy Apartment

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Do you own any pets?

No
Yes

If yes, type of pet?

Pet Weight

Will anyone in your household require special living accommodations or have special needs?*

No
Yes

If yes please explain

Has anyone from your household even been evicted, sued for rent, sued for property damage or even broken a lease for any reason?*

No
Yes

If yes please explain

Has anyone in your household ever failed to pay a debt, rent or judgement?*

No
Yes

If yes please explain

Have you, or anyone else who is to occupy the apartment, ever been convicted, pled guilty, no contest, received probation, deferred adjudication, court-ordered supervision, or pre-trial diversion for a felony, sex-related crime, or misdemeanor assault against another person?*

No
Yes

How did you hear about us?

If you selected Referral, Web Site, or Other, please give details here:

I hereby make application to lease and agree that the rent is payable the first of each month in advance. As consideration, I paid a deposit and application fee. Balance of deposit to be paid upon execution of the lease unless otherwise stated in the lease. I understand that, in addition, my application fee will be retained, to offset The Pointe Management Company’s cost, time, and effort in processing my application. Upon acceptance of this application, I agree to execute a lease. I recognize that, as part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained regarding my credit history, employment history, criminal history, and housekeeping history. This inquiry includes information as to my character, reputation, personal characteristics and mode of living. I understand that I may have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigation. Any false or incomplete information will result in the denial of your application. If discovered after you are approved and have moved in, we reserve the right to terminate your tenancy. In the event this application is accepted, but I subsequently refuse to sign a lease and/or take possession of the premises, the deposit will be forfeited as damages. I state that the information I have provided is true and correct to the best of my knowledge.

Applicant’s Electronic Signature*

Collection of Additional Personal Information*

By checking this box, I acknowledge and understand that someone from Pointe Management will be calling me to get social security numbers for all applicants for background checks.

Date*

* Electronic Signature I declare under penalties of perjury that I have examined this filing, and to the best of my knowledge and belief the information I have provided is correct, complete and legally binding upon me. By typing in my name on this application, I agree to conduct business electronically in accordance with the federal Electronic Signatures in Global and National Commerce Act (E-Sign), 15 U.S.C.A. §§ 7001-7031 (Supp. 2001). I further understand that transactions and/or signatures in records may not be denied legal effect solely because they are conducted, executed or prepared in electronic form, and that if a law requires or permits a record or signature to be in writing, an electronic record or signature satisfies that requirement. I acknowledge and freely consent that my typed-in name on this application shall constitute a binding electronic signature under the laws of the United States. I recognize that I may be entitled to a paper or other non-electronic form of this document. I understand that prior to my signing this application I can request printed copies should I wish to be supplied with such document copies. This form is an application for housing. I hereby certify, to the best of my knowledge or belief, that the information in the application is accurate and I agree to comply with the applicable ordinance.

Date

Addendum To Application*

By checking this box, I hereby authorize the Landlord or Landlord's agents to verify the information on the application. Verification or re-verification of any information contained in the application will be retained by Landlord. I hereby authorize Tenant Data Services Inc. to obtain information about me, including, but not limited to, this application, my credit, my tenant history, my check writing history, any court records and/or my criminal record, and I hereby authorize & Instruct any entity or person contacted by Tenant Data Services Inc. or the Landlord or Landlord's agents to release such information to them. Upon request, Tenant Data will provide the name & phone number of the source of the information used in the verification process.

Date

THE POINTE

TRANQUILITY POINTE

STANDING BEAR LAKE

Rental Application

Applicant Information

Emergency Contacts

Rental Application

Please Complete Most Recent 3 Years of Residencies

Current Residency

Previous Residency 1

Previous Residency 2

Rental Application

Employment Information

Previous Employer

Rental Application

Vehicle Information

Vehicle 2

Rental Application

Persons Other Than Applicant to Occupy Apartment

THE POINTE

TRANQUILITY POINTE

STANDING BEAR LAKE