• 703 Southmoor Place, Godfrey, IL 62035
  • 618-466-9006
PRELIMINARY APPLICATION FOR APARTMENTS
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    PRELIMINARY APPLICATION FOR APARTMENTS
    Please select apartment you are applying for
    Alhambra, ILBunker Hill, ILCoffeen, ILGreenville, ILWood River, IL
    !!! APPLICATION WILL NOT BE PROCESSED UNLESS ALL ITEMS ARE COMPLETED
    APPLICANT DETAILS:
    Name:
    Date of Birth:
    SSN:
    Gender (Optional):
    Phone#:
    Present Address:
    SPOUSE DETAILS:
    Spouse:
    Date of Birth:
    SSN:
    Gender (Optional):
    Spouse Phone#:
    MARITAL STATUS:
    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):
    NAME(S) & BIRTH DATES 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):
    CURRENT/MOST RECENT ADDRESS:
    Address:
    OwnRent
    Landlord:
    Phone:
    Monthly Payment:
    PREVIOUS ADDRESS:
    Address:
    OwnRent
    Landlord:
    Phone:
    Monthly Payment:
    IF PRESENTLY EMPLOYED:
    Employer's Name :
    Phone:
    Business Address:
    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: $
    REFERENCES:
    Bank:
    Phone #:
    Contact Person:
    Address:
    Credit:
    Phone #:
    Contact Person:
    Address:
    Credit:
    Phone #:
    Contact Person:
    Address:
    IN CASE OF EMERGENCY:
    Name:
    Phone #:
    Address:
    Name:
    Phone #:
    Address:
    Do you own a car?
    YesNo
    MAKE:
    MODEL:
    LTC#:
    Are you a U.S. citizen?
    YesNo
    Do you need special accommodations or modifications to the living unit because of a disability?
    YesNo
    Are you enrolled in an institution of higher education (Community College, University, Vocational School, Technical School)?
    YesNo
    If yes, are you a veteran?
    YesNo
    DATE OF OCCUPANCY DESIRED:
    NUMBER OF BEDROOMS REQUIRED:
    ILLEGAL ACTIVITY:
    Have you ever been convicted of illegal drug or alcohol use?
    YesNo
    Are you a registered Sex Offender?
    YesNo
    Have you or any member of your household been evicted from federally assisted Housing for drug-related activity during the last three (3) years?
    YesNo
    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-Head):
    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

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