APPLICATION FOR TENANCY

Date: Unit Address:

Move-in Date*: Lease Term:

*Move-in Date subject to availability

1st Applicant Information 2nd Applicant Information

Name: Name:

Soc Sec No: DOB: Soc Sec No: DOB:

Present Address: Present Address:

City: State: Zip: City: State: Zip:

How Long at Present Address: Phone: How Long at Present Address: Phone:

Present Landlord: Phone: Present Landlord: Phone:

Landlord Address: Landlord Address:

Employer: Phone: Employer: Phone:

Employer Address: Employer Address:

Occupation: Annual Income: Occupation: Annual Income:

Date of Hire: Date of Hire:

Previous Employer: Phone: Previous Employer: Phone:

Prev. Employer Address: Prev. Employer Address:

Personal Reference: Phone: Personal Reference: Phone:

Driver’s License: State: Driver’s License: State:

Auto Yr/Model/Color: License Plate: Auto Yr/Model/Color: License Plate:

Emergency Contact: Relation: Emergency Contact: Relation:

Address: City: State: Zip: Address: City: State: Zip:

Phone: Alt. Phone: Phone: Alt. Phone:

Bank: Branch: Bank: Branch:

Checking Acct #: Savings Acct #: Checking Acct #: Savings Acct #:

Subject to management’s approval, the undersigned applicant(s) hereby makes application to

Occupants Other Than Applicants lease the apartment described herein for the term and at the rental amount set forth.

Name: Age: Relation: As inducement to the management to approve this application, the undersigned applicant(s)
warrants that all of the representations set forth in this application are true and complete or shall
be deemed cause for rejection.
Name: Age: Relation:
Applicant(s) understands that the deposit is acknowledged as a non interest bearing deposit. In
the event applicant(s) cancels within 48 hours of the above date the deposit will be refunded to the
applicant(s). In the event this application is rejected, the deposit will be returned to the
Balance Due Before Possession applicant(s).
CERTIFICATION: I understand that the above information is confidential. I hereby certify that I
Rent $ For security reasons, have examined this application and that the above information made here is to the best of my
please fax or mail your knowledge and belief a true and complete application made in good faith. I also give my
Prorated Rent $ completed application. permission to have any of the above statements verified by utilizing reports from any credit
reporting agency.
Do not email.
Security Deposit $

TOTAL $ The Shaffran Companies, Ltd.

Applicant’s Signature Applicant’s Signature
209 S. Fourth Ave, Ste. 1C
Amt Recvd with App $ Ann Arbor, MI 48104
BALANCE DUE $
Tel: (734) 665-1200
Fax: (734) 665-9544 Authorized Rental Agent Date