Rental Application

ALL APPLICATIONS MUST BE ACCOMPANIED BY A NON-REFUNDABLE $40 SINGLE OR $50 JOINT APPLICATION FEE.

Name *

SSN

Social Security Number of Primary Applicant:

SSN - xxx *0 / 3

SSN - xx *0 / 2

SSN - xxxx *0 / 4

Will there be a co-applicant?Yes

Date Housing is Needed *

Date of Application *

Choose a Location *

Then choose from the following *

Billing Information for Application Fee

Card Information

First Name *

Last Name *

Card Number *0 / 16

CCV Code *0 / 3

Exp Date (mmyy) *0 / 7

Billing Address

Address *

City *

State *

Zipcode *

Email Address *

CURRENT PLACE OF RESIDENCY/EMERGENCY CONTACT

Current Address

Street Address *

City *

State *

Zipcode *

Current Telephone #

Home *

Work *

Message

Emergency Contact

Street Adress *

City *

State *

Zipcode *

Home Telephone *

Work Telephone *

Part 1: Family Composition

NAME ALL PEOPLE TO OCCUPY HOME: FIRST, MIDDLE, LAST. PLEASE ADD THE DATE OF BIRTH TO THE SECOND FIELD

First, Middle, Last

DOB

Do you expect a change in family size in the future? *YesNo

If so, explain change and provide expected date of change.

Do you expect a change in family size in the future? *YesNo

If so, provide name and date of return.

Return Date

Would you or any members of your household benefit from a handicapped-accessible unit? *YesNo

If so, explain:

PART 2: INCOME i.e. Job, Pension, SS, etc.

Type of Account *

Name on Account *

Name of Financial Institution *

Address, City, State, Zip, Phone number *

Account Number *

Type of Income *

Person Recieving Income *

Name of Source *

Address, City, State, Zip, Phone number *

Amount Recieved per week/month/year *

PART 3: ASSETS i.e. checking, savings, cd's

Instructions

Directions to Applicant

Directions to Applicant: Answer all questions on this application. Enter ''None'' or "N/A" for those questions which do not apply to you. Include all members who you anticipate will occupy the unit, at least 50% of the time during the next 12 months. For financial information, please provide the names and addresses of people who can verify the information you provide. All adults must sign/date the application and sign a Release of Information form when they meet with a housing representative.

PART 4: LANDLORD REFERENCE

A. Present Landlord

Name

From/To

Address

City

State

Zip

Phone

B. Previous Landlord

Name

From/To

Address

City

State

Zip

Phone

B. Previous Landlord

Name

PART 5: GENERAL INFORMATION

a. Have you or your spouse/co-applicant ever had your rental assistance terminated or been evicted or otherwise involuntarily removed from rental housing due to fraud, non-payment of rent, failure to cooperate with recertification procedures, or for any reason? If yes, please explain: *YesNo

If yes, please explain

b. Have you or anyone in your household ever been convicted of a felony? If yes, please explain: *YesNo

If yes, please explain

c. Have you ever filed bankruptcy? If yes, please explain: *YesNo

If yes, please explain

d. Have you ever recieved rental assistance or lived in subsidized housing? If yes, please explain: *YesNo

If yes, please explain

e. Will this be your only place of residence? If no, please explain: *YesNo

If yes, please explain

f. Do you have any pets? *YesNo

Cambridge Management Corporation Pet Policy allows one cat. There is a non-refundable pet fee.

g. Does anyone in your household smoke? *YesNo

Cambridge Management Corporation's communities are non-smoking.

h. Has anyone in your household used an alias or had their named changed (e.g. maiden)?YesNo

If so, who, and what was their prior name?

i. Have you or any member of your household ever made a prior application to this office?YesNo

If so, when and under what name?

j. Do you or any member of your household own any real estate?YesNo

If so, where, and what is the assessed value?

k. Some Funding for this site comes from the Ohio Department of Development, which requires us to report the following statistics to determine the degree to which its programs are utilized by minority families Please check the one that best applies to the Head of HouseholdWhiteHispanicAsian/Pacific IslanderAfrican/AmericanAmerican Italian/Alaskan Native

Other

By clicking the check box below, I certify that all application information is true and complete to the best of my knowledge. I understand that I will be required to provide third-party documentation of the above information at such time as I may be notified by the Cambridge Management Corporation. Applicant understands and agrees, as indicated by checking the box below, that deposit will be forfeited if applicant fails to lease home by date CMC establishes home is available for lease. *I Agree