Online Application for Residency

This form has been prepared for the members of the Wisconsin Apartment Association (WAA) and customers of Rental Housing Resources (RHA). Rental Housing Resources is unable to provide any representations or warrenties that this form complies with all current laws or regulations relating to rental of property. Lessors / Agents are adviced to consult with an attorney for local ordinance compliance and appropriateness to their situation.
Copyright 2000, All Rights Reserved, Rental Housing Resources, Inc.

General Information

Landlord:	Summit Development Group	Manager:	Summit Development Group
Address:	820 W. Walworth St. Elkhorn, WI 53121	Address:	820 W. Walworth St. Elkhorn, WI 53121
Phone #:	(262) 723-2881	Phone #:	(262) 723-2881

The undersigned hereby make application to rent aparement (unit #)

Located at:		Monthly Rent:
Lease Term:		Security Deposit

Household Information

Each adult applicant must complete a seperate application. Complete the following informaiton for each household member that will occupy the unit at the time of move-in and throughout the term of the lease.

APPLICATION MUST BE COMPLETED IN FULL. FALSIFICATION OF INFORMATION IS GROUNDS FOR DENAIL

Name: First, Middle, Last	M / F	Social Security Number	Date of Birth: Month/Day/Year

Daytime Phone #:

Evening Phone #:

Email Address (required):

Yes	No
		1. Do you expect any additions to the household within the next 12 months? Name & Relationship:
		2. Have you, or any other person named on this apliction, ever been convicted of a crime? Explanation:
		3. Do you have or do you anticipate having any pets? Explanation:

Applicant's Rental History

	Yes	No
Have you ever refused to pay rent?
Been evicted or asked to leave?

1.	Current Address:
	Rent:	From:	To:
	Landlord's Name:	Address:
	Phone #:	Fax#:

2.	Previous Address:
	Rent:	From:	To:
	Landlord's Name:	Address:
	Phone #:	Fax#:

3.	Previous Address:
	Rent:	From:	To:
	Landlord's Name:	Address:
	Phone #:	Fax#:

Emergency Information

Name and Relationship:
Address:
Phone Number:

Vehicle Information

Car #1	Make / Model / Year / Color:
	Plate #:
	Driver's License:

Car #2	Make / Model / Year / Color:
	Plate #:
	Driver's License:

Applicant Income

Place of Employment 1:		Address:
Hours Per Week:		Gross Monthly Income:
Employment Date From:		To:
Supervisor's Name:		Phone #:

Place of Employment 2:		Address:
Hours Per Week:		Gross Monthly Income:
Employment Date From:		To:
Supervisor's Name:		Phone #:

Applicant's Credit References

Have you ever filed for bankruptcy?

Yes

Credit Reference	Address & Phone #	Type & Account Number

Other Sources of Income

Will you be receiving any other income that you want considered with this application (e.g. Section 8 Rental Assistance, SSI, Social Security, public assistance, W-2, alimony, child support, savings, trust funds, scholarships, or any other type of income)? If so, please provide the following information for verification.

Source of income (Name of Agency):
Address of Agency:
Contact Person's Name: :
Phone#:
Amount of income:

Source of income (Name of Agency):
Address of Agency:
Contact Person's Name: :
Phone#:
Amount of income:

Self Employed Applicants: If you are self employed you will need to provide the following information: Tax returns, business license, bank records and/or vendor names, with addresses and phone numbers for verification.

Digital Signature Clause

The purpose of this application is to determine whether I qualify as a tenant. If my application is approved, the landlord and I shall sign a written lease.I have no rental agreement with the Landlord before the time of the lease signing.

I have paid the earnest money deposit and credit check fee indicated on this application. The earnest money deposit will be applid to my security deposit or my first month's rent if the Landlord enters into a lease or rental afreement with me. If this application is approved, and I fail to enter into a lease or rental agreement, the earnest money and any subsequent payments may be retained to compensate the Landlord's consts and damages, subject to the Landlord's duty to mitigate. If this application is rejected or withdrawn or if no action is taken by the of BLANK calendar day following receipt of the earnest money, the earnest money and any subsequent payments will be refunded by the end of the next business day. The credit check fee is non-refundable.

I hereby authorize the Lanlord and Manager to investigate my credit and financial resposibility, income, rental and eviction history, and the statements made in this application, and to obtain a consumer credit report on me from a consumer reporting agency that complies and maintains files on consumers on a nationwide basis. My performance under any lease or rental agreement that I may enter into with the landlord may be reported to such reporting agency.

I acknowledge that the Manager and the agents and employees thereof represent the interests of the Landlord, bu they also have a duty to treat all parties fairly and in accordance with fair housing law, and to disclose material adverse facts about the property.

I warrent and represent that I am at least 18 years of age and that all information and answers to the above questions are true and complete to the best of my knowledge. I understand that providing false information or making false statements may be grounds for denial of my application. I also understand that such action may result in criminal prenalties. I understand that my occupancy is contingent on meeting management's resident selection criteria.

I understand and agree to the above stated terms.