703 Southmoor Place, Godfrey, IL 62035
618-466-9006
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PRELIMINARY APPLICATION FOR APARTMENTS
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\ PRELIMINARY APPLICATION FOR APARTMENTS
Managing Agent:
Morrissey Contracting Co. Inc.
P.O. Box 67 Godfrey, IL 62035
Phone 618-466-9006
Fax 618-466-9558
PRELIMINARY APPLICATION FOR APARTMENTS
Date:
Please select apartment you are applying for
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!!! APPLICATION WILL NOT BE PROCESSED UNLESS ALL ITEMS ARE COMPLETED
APPLICANT DETAILS:
Name:
Date of Birth:
SSN:
Gender (Optional):
Phone#:
Email:
Present Address:
City:
State:
Zip:
CO-TENANT DETAILS:
Co-Tenant:
Date of Birth:
SSN:
Gender (Optional):
Co-Tenant Phone#:
Co-Tenant Email#:
MARITAL STATUS:
Married
Unmarried
Separated
DEPENDENT CHILDREN LIVING WITH YOU:
Name:
Date of Birth:
SSN:
Gender (Optional):
Name:
Date of Birth:
SSN:
Gender (Optional):
Name:
Date of Birth:
SSN:
Gender (Optional):
Name:
Date of Birth:
SSN:
Gender (Optional):
Disclosure of Social Security numbers is required for the applicant & all members of the applicant's Household, except those household members who do not contend eligible immigration status
CURRENT/MOST RECENT ADDRESS:
Address:
City:
State:
Zip:
Own
Rent
Landlord:
Phone:
Monthly Payment:
Dates you lived at this address: From:
To:
PREVIOUS ADDRESS:
Address:
City:
State:
Zip:
Own
Rent
Landlord:
Phone:
Monthly Payment:
Dates you lived at this address: From:
To:
IF PRESENTLY EMPLOYED:
Employer's Name :
Phone:
Business Address:
City:
State:
Start Date:
Annual Salary: $
SOURCES AND AMOUNTS OF ALL INCOME STATED IN ANNUAL GROSS DOLLARS:
Source:
Amount: $
Source:
Amount: $
Source:
Amount: $
ASSETS:
If you have disposed of assets at less than fair market value within the last two (2) years please describe:
Asset:
Fair Market Value: $
Sales Price: $
NAME(S) & BIRTHDATES OF PERSONS PLANNING TO OCCUPY APARTMENT
Name:
Date of Birth:
SSN:
Gender (Optional):
Name:
Date of Birth:
SSN:
Gender (Optional):
Name:
Date of Birth:
SSN:
Gender (Optional):
Name:
Date of Birth:
SSN:
Gender (Optional):
PETS:
None
Dog
Cat
Other
Service Animal:
Yes
No
REFERENCES:
Bank:
Phone #:
Contact Person:
Address:
Credit:
Phone #:
Contact Person:
Address:
Credit:
Phone #:
Contact Person:
Address:
IN CASE OF EMERGENCY: PLEASE LIST ONE OR TWO NAMES OF RELATIVES OR OTHER PERSONS, WHO ARE RESPONSIBLE FOR YOUR WELL-BEING OR BUSINESS
Name:
Phone #:
Address:
City:
State:
Zip:
Name:
Phone #:
Address:
City:
State:
Zip:
Do you own a car?
Yes
No
YEAR:
MAKE:
MODEL:
LTC#:
Are you a U.S. citizen?
Yes
No
Do you need special accommodations or modifications to the living unit because of a disability?
Yes
No
Are you enrolled in an institution of higher education (Community College, University, Vocational School, Technical School)?
Yes
No
If yes, are you a veteran?
Yes
No
DATE OF OCCUPANCY DESIRED:
NUMBER OF BEDROOMS REQUIRED:
ILLEGAL ACTIVITY:
Have you ever been convicted of illegal drug or alcohol use?
Yes
No
Are you a registered Sex Offender?
Yes
No
Have you or any member of your household been evicted from federally assisted Housing for drug-related activity during the last three (3) years?
Yes
No
LIST ALL STATES WHERE YOU HAVE LIVED SINCE 1996:
PLEASE NOTE THAT THIS IS A PRELIMINARY APPLICATION AND GIVES NO LEASE OR RENT RIGHTS. ADDITIONAL INFORMATION WILL BE REQUIRED AT A LATER DATE TO COMPLETE PROCESSING OF TENANTS.
I am applying for the rental of an apartment and hereby authorize Morrissey Contracting Company, Inc., Managing Agent for the apartments, to conduct a credit check and background check with any and all credit agencies and police agencies to include all arrests, convictions or pleadings. I have read and understand the above form and give my permission to check all named references. I hereby certify that the information I have provided is accurate and complete.
(A copy of my signature is deemed as valid as the original.)
Name (Head of Household):
Name (Spouse or Co-Tenant):
Date:
RACE/ETHNIC INFORMATION:
The following race/ethnic and marital status information solicited on this application is requested by the apartment owner in order to assure the Federal Government, acting through its Rural Development Administration, that Federal Laws prohibiting discrimination against tenant applicants on the basis of race, color, national origin, religion, sex, marital status, age, and handicap are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the race/national origin and sex of individual applicants on the basis of visual observation or surname.
HEAD OF HOUSEHOLD (check below as appropriate)
Racial/Ethnic Categories
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
Non-Hispanic or Latino
American Indian, Alaskan Native
Black or African American
White
Asian
Other
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