TEMPLATE Revised 07-08-2010 LS
DO NOT DUPLICATE
ONE APPLICATION PER HOUSEHOLD ONLY
The Studios at Hotel Berry
729 L Street, Sacramento, CA 95814APPLICATION FOR ADMISSION
The Studios at Hotel Berry will comply with the provisions of any federal, state or local law prohibiting discrimination inhousing on the basis of race, color, creed, ancestry, national origin, sex, sexual orientation, familial status, source of income, age, disability, AIDS, or AIDS relation condition.TDD Telephone device for the deaf only - California Relay Service (711).
Please fill in all blanks. Incomplete applications will not be processed.APPLICANT NAME
:DATE OF BIRTH: SOCIAL SECURITY #:
: APT. #:CITY, STATE, ZIP CODE:
HOME PHONE #
: WORK #: OTHER WORK #:CELL PHONE #: OTHER#:FAX #:E-MAIL: ________________________________ INDICATE TWO PEOPLE WHO GENERALLY KNOW HOW TO CONTACT YOU:1. NAME: ______________________________________ 2. NAME: ____________________________________ ADDRESS: ___________________________________ ADDRESS: ___________________________________ PHONE #:____________________________________ PHONE #:____________________________________ DO YOU OWN A CAR? _______
PORTIONS OF THIS COMMUNITY ARE NON-SMOKING
Smoking is prohibited in the common area on floor one (1) and the studio units on floors two (2), three (3) and four (4).Smoking is allowed inside the studio units on floors five (5) and (6), but prohibited in common areas and hallways onthese floors. Are you a smoker? YES _______ NO ________
CURRENT HOUSING STATUS
How many people live in your home now?