Name: ____________________________________Soc. Sec. No.:

Address (Street, City, State, Zip Code): ______________________________________________________________________

Email Address: _____________________________________________

Telephone No.: ___________________________ Fax No.: ________________________

Driver’s License State: __________________ Driver’s License No.: ________________________

Employer: ____________________________________ Employer’s Telephone No: _____________________

Employer’s Address (Street, City, State, Zip Code): ____________________________________________________________

Job Title: ____________________________________ Supervisor’s Name: ____________________________________

Length of Service: _________________________

Total number of persons to occupy apartment: __________

Name of potential occupants: Age:

______________________________________ ____________

Credit References:

Bank/Branch: ___________________________________________Checking Account Number:____________________

Bank/Branch : __________________________________________ Savings Account Number: _____________________

( if different from Checking Account)

Credit Card Type and Number: ___________________________________________

Finance Company: _______________________________ Item(s) Financed: _____________________________

Personal References:

Name: __________________________Address: ____________________________________ Phone No.: ____________
Name: __________________________Address: ____________________________________ Phone No.: ____________
Name: __________________________Address: ____________________________________ Phone No.: ____________

Rental History:

Former Landlord: ______________________Address: _____________________________ Phone No.: ______________

Other:

Monthly Rent: $_________ Security Deposit $____________

Reason for leaving present residence: ___________________________________

Type of Unit/Style Requested: ___________________________

Security Deposit: ________dollars ($_______) due and first month’s rent ________ dollars ($ ________) payable in advance to:
Bellevue Gardens Apartments

2606 Vine Street

Cincinnati, OH 45219

Note to Applicant: Lease/rental application will be reviewed when $50 non-refundable application fee is submitted with application. Applicant acknowledges by signature below that permission is granted for credit and reference checks to be conducted.

Applicant’s Signature: _____________________________________ Date: _____________

Office Use Only: Credit Check - Approved: _________ Disapproved: _______ __

Name: __________________________________________________________Soc. Sec. No.:______________________

Reason for leaving present residence: ___________________________________

Name: ____________________________________Soc. Sec. No.: