Untitled Document

The Heritage & Canterbury Apartments

100 Lakeshore Dr. , Lexington, KY 40502 (859) 266-4011
(on the corner of Richmond Rd. and Lakeshore Dr.)

Fill this form out if you want to apply for rent.
We will get back to you as soon as possible. Thank you for choosing Heritage Apartments.

Date Completed (Each co-resident must submit separate application.)

Name of Applicant Current Phone Date of Birth Drivers License No.

Present Address How Long?

Marital Status Social Security

City State, Zip

Applicant's Monthly Income Spouse's Monthly Income

Present Landlord or Apartment Community Phone

Address How Long?

Previous Address How Long?

Name of Spouse Date of Birth Social Security No.

List all other persons to occupy apartment in the box below:

Make of Car Year License No. State

Other Vehicles (trucks, boat, motorcycle)

Second Make of Car Year License no. State

Pets (keeping of pets requires a pet deposit and owner's consent)

Breed Wt. Age

Employment

Name of Employer Type of Work How Long?

Address City State, Zip Phone

Former Employer Type of Work How Long?

Address City State, Zip Phone

Does spouse work? Name of spouse's employer Type of Work How Long?

Spouse's Work Address City State, Zip Phone

Credit Banks
Bank Name Address
Check type of account: Checking Savings Loan Account No.

Bank Name Address
Check type of account: Checking Savings Loan Account No.

Name Address Account No.

Personal
Name (nearest relative) Address Phone
Name (nearest relative) Address Phone

Name of Doctor Address Phone

Have you ever been convicted of a felony? Yes No
Have you ever had a drug related conviction in the last 5 years? Yes No

Income
Additional Income: Additional income such as child support, alimony, or separate maintenance need not be disclosed unless such Additional Income is to be included for qualification hereunder.
Source Amount of per

Why are you leaving your present residence?
Have you ever been evicted? Yes No
Have you or your spouse ever broken a rental agreement or lease contract? Yes No
In case of emergency notify Phone

How were you referred to us? Check one: Just Stopped by Friend (Name)
Locator Agency Locator Agent's Name

Newspaper (Name) Other

Correct Information
Applicant represents that all of the above statements are true and complete, and hereby authorizes verification of the above information references and credit records. Applicant acknowledges that false information herein may constitute grounds for rejection of this application, termination of right of occupancy. and/or forfeiture of deposits and may constitute a criminal offense under the laws of this State. Applicant agrees to the terms of the "Application Deposit agreement" below.

Application Deposit Agreement-- Applicant has deposited the sum of $ , (hereafter referred to as "application deposit" in consideration for Owner taking the dwelling unit off the market while considering approval of this application. If Applicant is approved by Owner and the contemplated lease is entered into, the "application deposit" shall be credited to the required security deposit. If Applicant notifies the Owner that Applicant wishes to withdraw this application for rental prior to approval, or if Applicant is approved, but fails to promptly enter into the contemplated lease, the application deposit shall be forfeited to Owner. The application deposit will be refunded only if Applicant is not approved. Keys will be furnished only after contemplated lease and other rental documents have been properly executed by all parties, and only after applicable rentals and security deposits have been paid. This application is preliminary only and does not obligate Owner or Owner's Agent to execute a lease or deliver possession of the proposed premises.

Processing Fee-- Applicant has paid the sum of $ as a non-refundable fee for owner's cost of processing the application.
Apt. No. Apt. Type Anticipated Move in Date Term of Lease

I have read and agree to the provisions as stated.

Received by