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Revised 05/05/03

Terravita Homes Apartments




Referred by:
Move in Date:
Date: _______________________ Applicant can be reached at: Telephone Number: ______________________
A) APPLICANTS NAME: __________________________________________________________________
Date of Birth: __________________________________ Social Security No: __________________________
Occupation: _______________________Employer / Immediate Supervisor: __________________________
Approximate Weekly Salary: ________________________________________________________________
Employers Address: ____________________________________________City:______________________
How Long: _________ State: ______________Zip Code: ____________Telephone Number: ____________
B) CO-APPLICANT ______________________________________________________________________
Date of Birth: __________________________________Social Security No: __________________________
Occupation: __________________________Employer / Immediate Supervisor: _______________________
Approximate Weekly Salary: ________________________________________________________________
Employers Address: ____________________________________________City:______________________
C) NUMBER OF DEPENDENTS: _______________Ages: ________________________________________
Others to Occupy Apartment: Name: _____________________________Relationship:________________
Name: _____________________________DO B________________
D) Pets: Number: ___________ Kind and Breed: _______________________Color:______________________
E) PRESENT ADDRESS: _________________________________________________Zip Code:__________
Present Landlords Name or the Apartments Name: _____________________________________________
Telephone Number: _____________________Address:___________________________________________
City: ________________________________________How Long At This Address: ____________________
Amount of Rent: ___________________Reason For Leaving: _____________________________________

F) How long do you plan to live here? __________________________________________________________

G) Have you ever been asked to terminate your tenancy elsewhere: Or have you ever been evicted? Yes or No

Emergency Contact: _______________________________________________

Address: __________________________

City: ________________________ Phone:________________________

I) CAR (S) Make: __________ Model: _________ License No.: ___________ State: _______ Color: _________
J) (notes; comments; extra space;) Bring with you proof of income ; ID and all payments must be paid in money order

1. The Landlord has the right to either accept or reject this Application. If accepted, the deposit above specified will be credited
toward required security deposit. Applicant acknowledges that the security deposit is a non-interest bearing holding deposit.
If rejected for any reason, the deposit will be returned, the Tenant hereby waiving any claim for damage by reason of nonacceptance of the Application.

A non-refundable $____25.00_______________ fee will be required for processing costs and credit checks.

3. I agree to execute a written lease for said premises in the form customarily used for space in the building in which the premises
are located if and when you or the owner request me to do so and agree upon acceptance of this application to pay the balance
of the first months rent and security deposit. If after acceptance of this Application I fail or refuse to execute a lease when
requested to do so, or to pay such balance, the deposit may be retained by you as liquidated damages in payment for your time
and effort in processing my inquiry and this Application including making necessary investigation of my character and
reputation, and for withholding the rental property from the market on my behalf during this period.
4. I hereby apply to lease the above described premises for the term and upon conditions above set forth and agree that the rental
is payable the first day of each month in advance.
5. Landlord and agent will not be bound by any representations, agreements or promises made by representatives or agents unless
contained in the form of a lease signed by Landlord or representative of Landlord.

Revised 05/05/03

6. I / We understand that no pets are allowed at this apartment community. I / We also agree not to bring any pets to this
apartment community.
7. Within three (3) days after Landlords acceptance of Tenant, the applicant will pay the balance of the security deposit and
return the signed leases, upon failure to do so, the Application will be deemed to be withdrawn and both the Landlord and
Agent will be under no further obligation to applicant.

CRIMINAL RELEASE: The Nevada Criminal History Act effective July 1, 1979 provides that an Agency of Criminal Justice
must provide to a prospective landlord, upon request, records of criminal history concerning a prospective tenant which
reflect: 1) convictions as pertain to an incident for which the prospective tenant is currently within the system, including
Parole or Probation; 2) with Written consent of the prospective tenant to the Agency to provide all conviction and nonconviction data.
This release, therefore, allows both conviction and non-conviction data to be released to the prospective landlord listed below.
I, ________________________________________________________________________________, having made
application with, TERRAVITA APARTMENTS for residency, authorize release of any Record of Criminal History
pertaining to me. I hereby release the Sheriff of Clark County, Las Vegas Metropolitan Police Department and its employees
from any damage or liability in furnishing said Criminal History Record to the above listed prospective landlord.
Social Security #: _____________________________ Date of Birth: __________________
Social Security #: _____________________________ Date of Birth: __________________


GENERAL RELEASE: The undersigned hereby applies for an apartment unit and declares that all statements made for the
purpose of obtaining the apartment. Permission is hereby granted to the credit bureau to verify any information obtained from
any source named herein. I hereby authorize any present or former landlord to give any information he may have regarding me
in his capacity as landlord. Further, I hereby release such landlord or former landlord and his company or representatives
thereof from any and all liability for any damage or injury whatsoever caused for issuing the same. The Rental Application
submitted by Applicant is hereby made a part of this Lease. Applicant acknowledges that Landlord has relied on the
information submitted by Applicant as an inducement to rent the Premises to Applicant. If any representation on the
application is determined to be misleading, incorrect, or untrue, Landlord may, at its option, terminate Applicants right to
occupy the Premises. Landlord shall have the right to recover from Applicant any loss or damages which Landlord may suffer
because of such misrepresentation.



Date: _______________Building Name: Terravita Homes LLC Address: ___________________________

Apartment #:________ Las Vegas, NV_89115
Size: ____________ Floor Plan._________

Lease from: ________________ to: ______________ Credit Check: (yes) (no) Approval: ______________________
Term of Lease: Years: ____________ Mos.:______________
Basic Rent: $___________ Added Charges: W/S/T. $
Pet/ $
Total Monthly Charge:$______________
Security Deposit: $____________________ Date of Occupancy: _____________________ Cleaning Fee: $
Pet Deposit: $__________________ Refundable / Non-Refundable
Key Deposit: $_____________________ Misc.: $_______________________
Credit Fee: $_____________________
Actual Deposit and Fee Received With This Application: $_____________________________
Balance Due in For Deposit and Fee: $_____________________________________________