CO-SIGNER/GUARANTOR APPLICATION

Phone 773.256.8704 | Fax 773.289.0510

management@chidomicile.net

Today’s Date: _______________________

Co-Signer Application for: ___________________________________________________________________
For Property Located at: ___________________________________________________________________
Unit #: ________ Rent ($): _________________ Owner: _____________________

Co-Signer’s Name: _______________________________________ SSN: _____________________

License #: _______________________________________ State: _____________________
Address: _______________________________________ DOB: _____________________
City: ___________________ State: ____ Zip: ___________ Phone: _______________
Do you own or rent? ___________________ How long at current address: ________ yrs ________ mos
If less than 2 years how long at previous address? ____ yrs _____ mos Rent/Mortgage $ _____________

Have you ever been evicted? If yes, please explain the situation/outcome: _____________________________
_________________________________________________________________________________________
_________________________________________________________________________________________

EMPLOYMENT
Employer: ___________________________________ Occupation: __________________________________
Phone: _____________________________________ Start Date: __________________________________
Are you a student or unemployed? _______ If so what is your source of income? ________________________

I do hereby certify that the information on this application is correct and complete to the best of my knowledge. I do hereby authorize ChiDomicile, any of its staff and/or an
authorized representative to contact any prior or current employers, companies, credit bureaus, law enforcement agencies and/or consumer reporting bureaus. I agree to
pay a $40.00 application fee with this application. I authorize and consent to the recording, release and re-publication of this information to ChiDomicile and the
Landlord/Property Manager, without further permission, fee or compensation; and hereby release the above and their agents/servants and employees, from any and all
liability and responsibility for said re-use. The cosigner application may be submitted via fax, email or in person. The processing fee may be paid via Cash, Cashiers Check
or Money Order. *Please note the cosigner/guarantor will be required to sign the Lease*

COSIGNER’S SIGNATURE: ____________________________________________________ DATE: _________________________