GRAVES BROTHERS OF INDIANA, LLP

RENTAL APPLICATION

PROPERTY ADRESS: ______

DATE OF APPLICATION:______MOVE IN DATE______

PURCHASE PRICE $______DOWN PAYMENT______MONTHY RENT______

APPLICANT'S NAME ______

Home phone # ______Work Phone#______Cell phone#______

S.S. # ______Driver’s License#______State ______

Present Address: ______

NAMES AND SOCIAL SECURITY NUMBERS OF ALL OTHERS TO OCCUPY THIS UNIT:

Name: ______Social Security Number:______

Name: ______Social Security Number:______

Name: ______Social Security Number:______

Name: ______Social Security Number:______

APPLICANT'S PRESENT LANDLORD: ______

______

AddressCityStateZip

Phone# ______Dates Of Occupancy ______Rent Amount $______

Reason For Moving ______

PRESENT EMPLOYER______(Company Name)

______

Address

Phone# ______Monthly Take-Home Pay $______**

Supervisor______

Your Start Date: ______Your Job Title:______

SALARY____HOURLY____WEEKLY____BI-WEEKLY____MONTHLY____

** Photocopy of last 2 paychecks

PREVIOUS EMPLOYER______(Company Name)

______

Address

Phone#______Monthly Take-Home Pay $______

Supervisor:______

Dates of Employment:______Reason no longer employed______there:______

OTHER INCOME (DESCRIBE)______

Bank Accounts______[ ] CHECKING

Bank Name and LocationAccount #[ ] SAVINGS

Account balance $______

Bank Accounts______[ ] CHECKING

Bank Name and LocationAccount #[ ] SAVINGS

Account balance $______

Credit Reference______

Creditor name and LocationAccount #Phone #

Credit Reference______

Creditor name and LocationAccount #Phone #

GUARANTORS______

NameAddressPhone #

Social Security number______

Employer______Take home pay $______**

GUARANTORS______

NameAddressPhone #

Social Security number______

Employer______Take home pay______**

** Photocopy of last 2 paychecks

PET(S) Number ______Weight(S) ______Age(S) ______Housebroken [ ] Yes [ ] No

Type/Breed(S)______

AUTOMOBILES OWNED:Any co-owners?______

Year______Make______Model______Color______

VIN #______License#______State______

Lienholders______

Year______Make______Model______Color______

VIN #______License#______State______

Lienholders______

Other Vehicles: [ ] Trailers [ ] Boats [ ] Campers [ ] Vans [ ] M/Cycles

Details______

PERSONAL REFERENCE ______

NamePhone#

Address______

PERSONAL REFERENCE ______

NamePhone#

Address______

LOCAL FRIEND ______

NamePhone#

Address______

LOCAL FRIEND ______

NamePhone#

Address______

Address

MOTHER’S NAME ______

NamePhone#

Address______

Employer______

NamePhone #

FATHER’S NAME ______

NamePhone#

Address______

Employer______

NamePhone #

DOES APPLICANT HAVE DOWNPAYMENT NOW ? Yes____ No____

DOES APPLICANT HAVE FIRST MONTHS RENT NOW ? Yes____ No____

HAS APPLICANT OR ANY OTHER CO-APPLICANT OR PROPOSED RESIDENT:

Filed for Bankruptcy? [ ] Yes [ ] No When?______Resolution______

Been evicted from tenancy? [ ] Yes [ ] No

Have criminal record? [ ] Yes [ ] No Details______

Willfully or intentionally refused to pay rent when due? [ ] Yes [ ] No

APPLICATION DEPOSIT: Applicant herewith deposits $______[Cash] [Money Order] [Personal Check number______. This application will not be processed for approval until the application deposit has been paid and any personal check has cleared.

This application is made for the purpose of inducing ______(Landlord) to let to the Applicant, and all other Applicants, if appropriate, the premises located at ______. Applicant hereby authorizes Landlord to verify any and all parts of this application, authorizes all previous employers, landlords, credit references, and personal references to substantiate the above information, and releases all such persons from any and all liability for such disclosure.

Applicant herewith requests a possession date of ______, 20___ and agrees that if this Application shall be approved on or before ______, 20___, Applicant will execute Landlord's Residential Lease, a copy of which is available for was given to Applicant , will pay a security deposit of $______and the first month's rent of $______, and will accept possession of the leased premises.

In the event that this Application shall be denied by reason of lack of sufficient creditworthiness on the part of Tenant, Landlord shall have the right to retain from Tenant's application deposit an amount equal to Landlord's cost of the credit report and other verifications of the terms of the representations contained in this Application. OPTION: If this Application is approved and Applicant shall execute Landlord's Lease, then Landlord shall apply the full amount of the application deposit to the security deposit described in the Lease. If this Application is approved and Tenant shall fail to execute Landlord's Lease, accept possession, or pay all amounts due under the Lease, then Landlord shall have the right to retain all of the Application Deposit as liquidated damages for breach by Tenant of this Application.

Applicant has contacted the Guarantor(s) and each Guarantor has assured Applicant that he or she will guaranty all of the obligations of Applicant under the proposed Lease.

______

Signature of ApplicantDate

______

Signature of ApplicantDate

______

Signature of ApplicantDate

______

Signature of GuarantorDate

______

Signature of GuarantorDate

*WHEN COMPLETED, PLEASE FAX APPLICATION TO 317-889-5731

FOR OFFICE USE ONLY

UNIT ADDRESS______

DATE APP. SUBMITTED______APPLICATION FEE $______

DATE APPROVED______APPROVED BY______

DATE REJECTED______REJECTED BY______

REASON______

DATE AND TIME APPLICANT WAS INFORMED______

ADVERTISED MONTHLY RENT$______ADVERTISED SECURITY DEPOSIT$______

PET CHGS $______OTHER CHGS $______REMARKS______

* WAS LEASED OFFERED UNDER TERMS DIFFERENT THAN ADVERTISED TERMS?______REASON______

[ ] Copy Picture I.D. [ ] Recent Pay Stub [ ] Applicant's W2's [ ] Tax Returns [ ] Income Verification

[ ] Present Landlord [ ] Prior Landlord [ ] Guarantor(s) [ ] Personal Reference [ ] Expected Move-in Date [ ] Move-in Date______, 20___

* WAS A CREDIT REPORT/TENANT SCREENING SERVICE USED? ______IF SO, WHEN WAS ADVERSE ACTION NOTICE SENT TO TENANT?______