Full Name:  (exactly as on driver's license or govt. ID card)

Street address: (include city, state and zip)

Driver's License number and state:

OR govt. photo ID number:

Former last names: (maiden and married)

Your Social Security number:

Marital status:
single married divorced widowed separated

Are you a U.S. Citizen: Yes No

Current home address: (where you now live)

City/state/zip:

Phone number: (with Area Code)

Current monthly rent:

Name of apartment where you now live:

Current owner or manager's name:

Their phone number:

Date moved in:

Why are you leaving your current residence?

Your previous home address:

City/state/zip:

Name of apartment:

Name of owner or manager:

Their phone number:

Previous monthly rent:

Date you moved in:    
Date you moved out:  

Present employer:

Street address:

City/state/zip:

Work phone number: (with Area Code)

Position:

Your gross monthly income is over:
$
Date you began this job:

Supervisor's name/phone number:

Previous employer:

Street address:

City/state/zip:

Work phone number: (with Area Code)

Position:

Your gross monthly income was over:
$
Dates you began and ended this job:

Supervisor's name/phone number:

Your bank's name, city & state:

List major credit cards:

Other non-work income you want considered. Please explain:

Have you or your spouse ever owned a home? Yes No

If you have any past credit problems, send a separate email message explaining them to the property to which you are submitting the application. If no explanation is provided and problems are present, your application may not be approved.

Have you, your spouse, or any occupant listed above ever:

Please indicate the year, location and type of each felony and sex crime other than those resolved by dismissal or aquittal. We may need to discuss more facts before making a decision.

You represent the answer is "no" to any item not checked above.

Full Name: (exactly as on driver's license or govt. ID card)

Former last names: (maiden and married):

Spouse's Social Security number:

Driver's license number and state:

OR govt. photo ID number:

Are you a U.S. Citizen: Yes No

Present employer:

Street address:

City/state/zip:

Work phone number: (with Area Code)

Position:

Date you began this job:

Your gross monthly income is over:
$
Supervisor's name and phone:

Names of all persons under 18 and other adults who will occupy the unit without signing the lease. Please email additional occupants if more than three.

List all vehicles to be parked by you, your spouse, or any occupants (including cars, trucks, motorcycles, trailers, etc.). Continue on separate email if more than three.

Make and color of vehicle:
Year:  
License number :     State:

Make and color of vehicle:
Year:  
License number :     State:

Make and color of vehicle:
Year:  
License number :     State:

Will you or any other occupant have an animal? Yes No
Kind, weight, breed, age: 

Do you or any occupant smoke?  Yes No

How were you referred?

Emergency contact person over 18, who will not be living with you:

Name:

Address:

City/state/zip:

Work phone number: (with Area Code)

Home phone number: (with Area Code)

Relationship:

If you are seriously ill, missing, or in a jail or penitentiary according to an affidavit of (check one or more)

the above person
your spouse, or
your parent or child

we may allow such person(s) to enter your dwelling to remove all contents, as well as your property in the mailbox, storerooms, and common areas. If no box is checked, any of the above are authorized at our option. If you are seriously ill or injured, you authorize us to send for an ambulance at your expense. We are not legally obligated to do so.

If you are seriously ill or injured, what doctor may we notify:
(We are not responsible for providing medical information to doctors or emergency personnel.)

Doctor's name:

Phone number: (with Area Code)

Important medical information in emergency:

Type of apartment you wish to rent:

  Efficiency

   1 Bedroom

   2 Bedroom

   3 Bedroom

  Other

Price range:

   Less than $500

   $500 to $599

   $600 to $699

   $700 to $799

   $800 to $899

  $900 to $999

  $1,000 to $1,199

  $1,200 to $1,399

   $1,400 or more

   Other 

By typing your full name in the space provided below, you declare that all your statements in this application are true and complete. By submitting this electronic application, you authorize the property to which you are applying to verify this information through any means, including consumer reporting agencies and other rental housing owners. If you fail to answer any question or give false information, the property may reject your application, retain all application fees and deposits as liquidated damages for its time and expense, and terminate your right of occupancy. Giving false information is a serious criminal offense. In lawsuits relating to the application or Lease Contract, the prevailing party may recover all attorneys' fees and litigation costs from the losing party. The property may at any time furnish information to consumer reporting agencies and other rental housing owners regarding your performance of your legal obligations, including both favorable and unfavorable information about your compliance with the Lease Contract, the rules and financial obligations.

Authorized/Acknowledged by:

(Type your full name here)

To view our Privacy Policy click here.

The rental property to which you are submitting the information on this application has put a security system in place to protect your submitted personal information from misuse. The submission of this application will be encrypted through the utilization of 256-bit encryption technology, providing strong and reliable data protection from misuse. When the information reaches the appropriate property, it will be decoded by software held onsite at the property for processing. The information will be readable only to them. All rental properties that participate in this application processing have posted privacy statements outlining the manner in which your personal information will be protected at the property, and it has instructed its staff to handle the information in strict secrecy. Your profile will not be used beyond the scope of this application, and it will be held in the strictest confidence in an attempt to fully insulate you from any harms which might arise from misuse. Still, however, even such precautions may not be sufficient to guarantee that there will be no breach of the submitted data.

The following information is mandatory for the completion of this electronic rental application.

After you submit this electronic application, you may be contacted by the property for any additional information or requirements needed to complete the application process. Please provide the following contact information:

Phone number where we may reach you during business hours: (with Area Code)

Type any comments or special requests you may have below:

CBI Management does not charge application fees.  You will need to pay the application deposit to start the verification process. This amount is commonly equal to one months rent.  If you are approved we will notify  you and your application deposit will be credited towards the security deposit.   If you fail to sign a lease after notice of approval, CBI Management may keep your application deposit as liquidated damages.  If your application is turned down by CBI Management your application deposit will be returned to you.

For further details, please ask to see the back side of the application
form.