17 Forge Hill Drive, Ilion, NY 13357 315-895-7150

Residential Rental Application

Type of Unit Requested:
How Did You Hear About Us?
Desired Date of Occupancy:
Name of Tenant:
Social Security #:
Have you used any other name in the past?
If so, what name?
Date of Birth:
Number of Occupants:
Adults (Over 18):
Children (Under 18):
Name, Age, Sex, Relationship and Date of Birth of Children (Federal, State Assisted ONLY):
Residence History (For past five (5) years)
A. PRESENT ADDRESS:
Present Phone #
Length of time at Present Address:
Present Landlord or Mortgage Holder:
Telephone:
Amount of Rent:
Reason For Moving:
B. PREVIOUS ADDRESS #1:
Length of Time at Previous Address:
Landlord or Mortgage Holder:
Telephone:
Amount of Rent:
C. PREVIOUS ADDRESS #2:
Length of Time at Previous Address:
Landlord or Mortgage Holder:
Telephone:
Amount of Rent:
Employment Information
EMPLOYED BY:
How Long?
Employer's Address:
Telephone #:
Position Held:
Department:
Supervisor:
Present Income:
Gross Per Year:
If Student, List School:
School Address:
Present Grade Level:
Expected Date of Graduation:
Annual Income:
Other Income (If Social Services, name of caseworker, zone # and telephone):
Annual Retirement Income for Last 3 Years:
Banking and Character Refrences
Bank #1:
Branch Address:
Account #:
Account Type:
Bank #2:
Branch Address:
Account #:
Account Type:
Character Reference:
Address:
Character Reference:
Address:
Co-Tenant Information
Name of Co-Tenant:

Social Security #
Date of Birth:
Co-Tenant Residence History
A. PRESENT ADDRESS:
Present Phone #
Length of time at Present Address:
Present Landlord or Mortgage Holder:
Telephone:
Amount of Rent:
Reason For Moving:
B. PREVIOUS ADDRESS:
Length of Time at Previous Address:
Landlord or Mortgage Holder:
Telephone:
Amount of Rent:
Co-Tenant Employment Information
EMPLOYED BY:
How Long?
Employer's Address:
Telephone #:
Position Held:
Department:
Supervisor:
Present Income:
Gross Per Year:
If Student, List School:
School Address:
Present Grade Level:
Expected Date of Graduation:
Annual Income:
Other Income (If Social Services, name of caseworker, zone # and telephone):
Annual Retirement Income for Last 3 Years:
Co-Tenant Banking and Character Refrences
Bank #1:
Branch Address:
Account #:
Account Type:
Bank #2:
Branch Address:
Account #:
Account Type:
Character Reference:
Address:
Character Reference:
Address:
Additional Information
Number of Vehicles:
Make/Model:
Year:
Color:
License No.
Make/Model:
Year:
Color:
License No.
Applicant's Drivers License #:
Co-Tenant's Drivers License #:
In Case of Emergency, Notify:
Relationship:
Address:
Telephone(s):

Acceptance of this application, and any monies deposited herewith, is not binding upon Landlord until approved by Landlord. By clicking "Submit Application," I fully understand that a credit report will be taken through TRW. Residence at Forge Hill Estates is a month-to-month tenancy subject to Rules of Occupancy from time to time promulgated by Landlord.

By clicking "Submit Application," the applicant acknowledges receipt and acceptance of the Rules of Occupancy.

By clicking "Submit Application," the applicant recognizes that the Landlord or his agent may investigate the information supplied by the applicant and a full disclosure of pertinent facts may be made to the Landlord.

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