RENTAL APPLICATION - RENTCafe

1 RENTAL APPLICATIONName of Property _____Date _____How did you hear about us? (Select One) ____ Agency ____Apartment Guide ____Bus/Billboard ____Church ____Direct Mail ____Drive By ____Employee ____Friend/Relative/Resident ____ Housing Authority ____Newspaper ____Website ____ Word of Mouth ____OtherWhat attracted you to this property? (Select One) ____ Appearance/Design ____Availability ____Close to Good School ____Close to Public Transit ____Close to Work ____Employee Referral ____Neighborhood ____Price ____Project Amenities ____Resident Referral ____OtherApartment size desired- Number of Bedrooms: _____PLEASE PRINT AND ANSWER ALL QUESTIONS.

2 DO NOT leave any space blank, write "NO or NONE" where appropriate1. APPLICANT INFORMATION and RESIDENCE HISTORYR eason for Leaving Current Address: Location (1) Price (2) Excessive Cost of Utilities (3) Appearance/Design/Quality (4) Management (5) Increase in Income (6) Decrease in Income (7) Change in Household Composition (8) Undesirable Neighborhood (9) Please show at least 2 years of residence history, including any owned by applicantsCurrent Address Move-In DatePrevious Address Did you own this residence (yes or no)?Rent/Mrtg PmtUtilities/MOMove-In DatePrevious Address Did you own this residence (yes or no)?

3 Rent/Mrtg PmtUtilities/MOMove-In DateMove-Out Date: Reason for Leaving (use code above): Reason for Leaving (use code above): Name of Head of Household (Head):Spouse's Name (if living with the household):E-mail address (Head) E-mail address (Spouse)Landlord Phone:Landlord Name and Address (if rented):Do you own this residence (yes or no)?Home Phone #:Cell #:Cell #:Home Phone #:Utilities/MORent/Mrtg PmtMove-Out Date: Landlord Name and Address (if rented):Landlord Phone:Landlord Name and Address (if rented):Landlord Phone:Applicant Name _____(c) 2015 McCormack Baron Management Inc. 1 2. HOUSEHOLD COMPOSITION: PLEASE PRINT List all persons who will be residing in this household, even those completing their own applicationMember # Relation to HeadGenderDate of Birth MM/DD/YYLives in Household 100% (Y/N) Percentage of Time1 Head23456 Anticipated changes in household size?

4 (Y/N) ____ If yes, please explain _____Have you ever used another name? (Y/N)_____ If so, please indicate name _____Is any member subject to a Lifetime Sex Offender registration in any state? (Y/N) ____ State(s) _____3. EDUCATION INFORMATION: PLEASE PRINT LIST ALL HOUSEHOLD MEMBERS. Keep the 'Member #' the same as listed above. The use of N/A is not acceptable123456 Anticipated change in number of students? (Y/N) ____ If yes, please explain_____4. VEHICLES (including company cars, motorcycles, etc. )Member #Driver's License Number StateModelYearColorLicense Place Number StateMonthly PaymentType of School (pre-K, elementary, trade school, college, etc.)Member #Currently a Student?

5 Y/NRec'd Diploma/DegreeY/N Last Year of School AttendanceLast Grade Level CompletedName of SchoolSSNName(s)Applicant Name _____(c) 2015 McCormack Baron Management Inc. 2 5. ANTICIPATED INCOME: ALL PRESENT EMPLOYMENT AND OTHER INCOME RECEIVED BY YOU AND/OR MINOR CHILDREN OF WHICH YOU HAVE DIRECT CUSTODY OR CARE MUST BE LISTED HERE If Employment: Name of Employer If no employment: Name of source, AFDC, alimony, child support, employment, general assistance, pension, social security, TANF, unemployment, etc. Income Start Date: _____# of Hours workedIncome from this source $_____/moper week: Income Start Date: _____# of Hours workedIncome from this source $_____/moper week: Income Start Date: _____# of Hours workedIncome from this source $_____/moper week: 6.

6 ASSETS: List all assets owned by the adult(s) completing this APPLICATION (and/or their minor children). Do not include personal property (cars, jewelry, etc.).Member #Describe Type (checking, savings, CDs, cash, debit cards, stocks, bonds, real estate, retirement accts., etc.)Value of Asset Checking Debit Card Savings Retirement Acct None Other (describe)$ Checking Debit Card Savings Retirement Acct None Other (describe)$ Checking Debit Card Savings Retirement Acct None Other (describe)$ Checking Debit Card Savings Retirement Acct None Other (describe)$Are the total household assets and bank account balances equal to or greater than $5,000?

7 (Y/N) _____Have you disposed of any assets ( real estate, cash, stock, etc.) in the past two years? (Y/N) _____If yes, please describe _____7. SPECIAL NEEDS: Does anyone in your household have special needs? (Y/N) _____ Special living accommodations required? (Y/N) _____Please explain (attach additional pages as needed): _____8. PETS: Do you have any pets? (Y/N) _____ How Many? _____ Type _____ Weight _____Member #Source/NameOccupation if employed (see code):Address:Contact Phone NumberContact Name:Contact Fax NumberMember #Source/NameOccupation if employed (see code):Address:Contact Phone NumberContact Name:Contact Fax NumberMember #Source/NameAddress:Contact Name:Occupation if employed (see code):Contact Phone NumberContact Fax NumberApplicant Name _____(c) 2015 McCormack Baron Management Inc.

8 3 9. HEALTH INSURANCE: The following information is requested, not required. Not responding WILL NOT impact your APPLICATION for #Type of Health Insurance Employer MC+ Medicaid Medicare Medicare Advantage VA None Other Employer MC+ Medicaid Medicare Medicare Advantage VA None Other Employer MC+ Medicaid Medicare Medicare Advantage VA None Other Employer MC+ Medicaid Medicare Medicare Advantage VA None Other Opt Out Initials Date 10. COMMUNITY PROGRAMS: If any of the following programs or opportunities were offered by partner organizations in this neighborhood, would you or members of your household be interested in using them?

9 (Y/N) _____ If Yes, select all that apply ____Early Childhood/Children program ____After school or summer program ____Adult education program ____Fitness & Healthy living program ____Opportunities to volunteer with children and youth program (tutoring, sports, etc.) ____Technology training programI/We authorize McCormack BaronManagement, Inc. agent for the Property, and LandLord Shield Inc., as the authorized 3rd party agency to verify information on this APPLICATION and to do a complete investigation of all information provided. A complete investigation may include any or all of the following: credit report, criminal record, employment or RENTAL history references and personal interviews with above references.

10 I/We acknowledge LandLord Shield, not participate in the approval or denial process. I/We have personally filled in and/or reviewed all information listed above and that my/our signaturesbelow authorizes the release of RENTAL , job history (including salary) and criminal information. I/We understand this APPLICATION may be rejected as the result of my/our misrepresentation or insufficient of this APPLICATION and any deposits is not binding upon McCormack Baron Management, Inc. until APPLICATION is approved in understand that this APPLICATION and all related inquires will be used only for its relevance to screening and occupancy at this OF ALL PARTIES TO THIS APPLICATION , 18 YEARS OR OLDER:Applicant Signature (HEAD)DateApplicant Printed Name (HEAD)Applicant SignatureDateApplicant Printed NameProperty Representative SignatureDateProperty Representative Printed NameFor Office Use OnlyMBM 01/2015 Supersedes MBRMS 10/2014 Applicant Fee Rec'd: $_____ Reservation Deposit Rec'd: $_____By: _____ Date: _____Date Apartment Desired: _____Applicant Name _____(c) 2015 McCormack Baron Management Inc.