Rental Application

$60 non-refundable fee per person. Each applicant must make 3 times the rent.

Personal information

Property applying for

Rent

Full name

Last, First and MI

Social security #

Birth date

Cell phone

Home phone

Work phone

Driver's license #

State of issue

Rental history

Current address

How long?

City

State

Zip code

Name of landlord

Landlord phone #

Prior Address

City

State

Zip code

Name of prior landlord

Landlord phone #

Employment history

Current employer

Position

Supervisor name

Supervisor phone #

How long?

Monthly income

If military, provide rank

Previous employer

How long?

Other occupancy information

# of adults

# of children

# of pets

Breed

Weight

Please provide documentation for service animals prior to move-in.

Name of bank

Bank address

Bank phone #

# of vehicles owned

Make

Model

Have you ever filed for bankruptcy?

If yes, what date did you file for bankruptcy?

Have you ever been served an eviction notice?

If yes, what date were you served the eviction notice?

Haver you ever willfully or intentionally refused to pay rent?

Have you ever been convicted of a felony or pled "no contest" to any crime?

Criminal records must contain no convictions for felonies within the past 7 years involving the manufacture or distribution of controlled substances. For other felony convictions, we will conduct individualized assessments that take into account mitigating factors, such as facts & circumstances surrounding the criminal conduct, evidence of good tenancy before and after conduct, nature & severity of conviction and the amount of time that has passed since the conviction. Criminal history which indicates that an applicant’s tenancy would constitute a direct threat to the health or safety of other individuals or whose tenancy could result in substantial physical damage to the property of the owner or others may result in rejection of the application.

If yes, what date were convicted or did you plead "no contest"

Have you ever been involved in a lawsuit?

Do you smoke?

DISCLOSURE I/WE, THE UNDERSIGNED UNDERSTAND THAT ROSEWOOD REALTY, INC. IS THE LEASING AGENT AND REPRESENTATIVE OF THE OWNER/LANDLORD AND THAT THE LEASING AGENT FEES WILL BE PAID BY THE OWNER/LANDLORD. THE UNDERSIGNED ACKNOWLEDGES THAT THIS WRITTEN NOTICE WAS RECEIVED PRIOR TO THE UNDERSIGNED RECEIVING A LEASE AGREEMENT.

RENTER’S INSURANCE: PROOF OF RENTER’S INSURANCE WILL BE required WITHIN FIVE (5) DAYS OF LEASE SIGNING!

RADON GAS: NOTICE TO PROSPECTIVE TENANT: RADON IS A NATURALLY OCCURRING RADIOACTIVE GAS THAT, WHEN IT HAS ACCUMULATED IN A BUILDING IN SUFFICIENT QUANTITIES, MAY PRESENT HEALTH RISKS TO PERSONS WHO ARE EXPOSED TO IT OVER TIME. LEVELS OF RADON THAT EXCEED FEDERAL AND STATE GUIDELINES HAVE BEEN FOUND IN BUILDINGS IN THIS STATE. ADDITIONAL INFORMATION REGARDING RADON AND RADON TESTING MAY BE OBTAINED FROM YOUR COUNTY PUBLIC HEALTH UNIT.

AUTHORIZATION: I HEREBY AUTHORIZE PROPERTY MANAGER, TO VERIFY ALL INFORMATION CONTAINED ON THIS APPLICATION, AND CONDUCT A FULL BACKGROUND CHECK INCLUDING, BUT NOT LIMITED TO CREDIT, BANK ACCOUNT, EMPLOYMENT, EVICTION, CRIMINAL BACKGROUND CHECKS, AND AUTHORIZE PROPERTY MANAGER TO CONTACT ANY PERSONS OR COMPANIES LISTED ON THIS APPLICATION.

CORRECT INFORMATION: I AFFIRM THAT ALL THE INFORMATION ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE AND HEREBY AGREE THAT IF THIS IS NOT SO, MY APPLICATION MAY BE DENIED AND/OR MY LEASE MAY BE HELD IN DEFAULT AND I MAY BE SUBJECT TO EVICTION.

LEAD BASED PAINT: HOUSING BUILT BEFORE 1978 MAY CONTAIN LEAD BASED PAINT. LEAD FROM PAINT, PAINT CHIPS, AND DUST CAN POSE HEALTH HAZARDS IF NOT MANAGED PROPERLY. LEAD EXPOSURE IS ESPECIALLY HARMFUL TO YOUNG CHILDREN AND PREGNANT WOMEN. BEFORE RENTING PRE-1978 HOUSING, LESSORS MUST DISCLOSE THE PRESENCE OF LEAD BASED PAINT, AND/OR LEAD BASED PAINT HAZARDS IN THE DWELLING. LEESEES MUST ALSO RECEIVE A FEDERALLY APPROVED PAMPHLET ON LEAD BASED POISONING PREVENTION. LEAD BASED HOUSING ADDENDUM WILL BE INCLUDED WITH LEASE FOR ALL HOUSING BUILT PRIOR TO 1978.

SEXUAL OFFENDER DISCLOSURE: THE FLORIDA DEPARTMENT OF LAW ENFORCEMENT(FDLE) MAINTAINS A LIST OF SEXUAL PREDATORS/OFFENDERS TO ENABLE THE PUBLIC TO REQUEST INFORMATION ABOUT THESE INDIVIDUALS WHO MAY BE LIVING IN THEIR COMMUNITIES. IF THIS IS IMPORTANT TO YOU, CONTACT FDLE DIRECTLY PRIOR TO ENTERING INTO A CONTRACT AT 1-800-357-7332 (TOLL FREE), VIA E-MAIL AT SEXPRED@FDLE.STATE.FL.US, OR LOG ON TO WWW.FDLE.STATE.FL.US.

NON REFUNDABLE LEASE APPLICATION FEE: $60.00 EACH APPLICANT, TO BE PAID WITH APPLICATION.

SECURITY DEPOSIT: I HEREBY DEPOSIT THE SUM OF $__________WITH MANAGEMENT AS A SECURITY DEPOSIT. IF I DO NOT CANCEL THIS APPLICATION WITHIN 24 HOURS FROM THE DATE AND TIME OF THIS APPLICATION, IN WRITING, AND BY HAND DELIVERY TO THE RENTAL OFFICE, AND MY APPLICATION IS APPROVED, AND I FAIL TO ENTER INTO THE RENTAL AGREEMENT, OR FAIL TO TAKE POSSESSION BY COMMENCEMENT DATE AND UNDER THE TERMS OF THE RENTAL AGREEMENT, I UNDERSTAND THAT THE ENTIRE SECURITY DEPOSIT SHALL BE FORFEITED BY ME. IF I HAVE CANCELLED THIS APPLICATION WITHIN THE TIME PERIOD SET FORTH ABOVE, I WILL RECEIVE A REFUND OF MY SECURITY DEPOSIT IN FULL WITHIN 30 DAYS.

Your signature

By signing you agree to all of the conditions as written. You also agree that this signature will be legally binding as allowed by the ESIGN act.

Effective October 1, 2000, The Electronic Signatures in Global and National Commerce Act states that electronic signatures are widely recognized as legally binding. "[A] signature, contract, or other record relating to such transaction may not be denied legal effect, validity, or enforceability solely because it is in electronic form; and (2) a contract relating to such transaction may not be denied legal effect, validity, or enforceability solely because an electronic signature or electronic record was used in its formation."