COLONIAL PROPERTY MANAGEMENT, INC.

704 VIRGINIA ST., W

CHARLESTON, WV 25302
(304) 344-8051
(304) 343-6242 - FAX
RENTAL APPLICATION - NO PETS

THE UNDERSIGNED HEREBY MAKES APPLICATION TO RENT ___________________________________________

(address)
======================================================================================================

NAME OF APPLICANT_________________________________________________ PHONE _____________________

DATE OF BIRTH __________________________ SOCIAL SECURITY NO. _____________________________________
# PEOPLE IN HOUSEHOLD _________________________ AGES _____________________________________________
PETS (NUMBER & KIND) _____________________________________________________________________________
CURRENT ADDRESS _________________________________________________________________________________
CITY __________________________ STATE _________ ZIP CODE _____________ HOW LONG HERE _____________
LANDLORDS NAME & PHONE _________________________________________________________________________
AMOUNT OF RENT NOW PAYING ______________________ REASON FOR MOVING __________________________
EMPLOYED BY __________________________________________________ PHONE _____________________________
EMPLOYED HERE SINCE _____________ SALARY _____________ MO/WK ____ POSITION _____________________
HAVE YOU EVER FILED BANKRUPTCY?

YES _________ NO _________

HAVE YOU BEEN EVICTED FROM TENANCY?

YES ________ NO ________

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NAME OF CO-APPLICANT ___________________________________________ PHONE ________________________
DATE OF BIRTH _____________________________ SOCIAL SECURITY NO. ___________________________________
# PEOPLE IN HOUSEHOLD _________________ AGES ______________________________________________________
PETS (NUMBER & KIND ) ______________________________________________________________________________
CURRENT ADDRESS __________________________________________________________________________________
CITY _________________________ STATE __________ ZIP CODE _____________ HOW LONG HERE ______________
LANDLORDS NAME & PHONE _________________________________________________________________________
AMOUNT OF RENT NOW PAYING ______________________ REASON FOR MOVING __________________________
EMPLOYED BY _____________________________________________________________ PHONE __________________
EMPLOYED HERE SINCE ______________ SALARY _______________ MO/WK ____POSITION__________________
HAVE YOU EVER FILED BANKRUPTCY?

YES _________ NO _________

HAVE YOU BEEN EVICTED FROM TENANCY?

YES ________ NO ________

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PLEASE COMPLETE OTHER SIDE OF THIS APPLICATION

CREDIT REFERENCES:
1. __________________________________________________________________________________________
2. __________________________________________________________________________________________
IN CASE OF EMERGENCY NOTIFY __________________________________________________________
RELATION ______________________________________________ PHONE ____________________________
ADDRESS ___________________________________________________________________________________
LAST 5 YEARS RENTAL HISTORY
ADDRESS

LANDLORDS NAME

DATE OF RESIDENCY

REASON FOR MOVING

1._____________________________________________________________________________________________________
2._____________________________________________________________________________________________________
3._____________________________________________________________________________________________________
4._____________________________________________________________________________________________________
5._____________________________________________________________________________________________________

NAME/ADDRESS OF ATTORNEY REPRESENTING APPLICANTS (if applicable)

______________________________________________________________________________________________________
I/WE HEREBY APPLY TO LEASE FROM COLONIAL PROPERTY MANAGEMENT, INC. UNDER A SIGNED LEASE AGREEMENT AND
HEREBY STATE THAT THE INFORMATION GIVEN IN THIS APPLICATION IS TRUE AND CORRECT. 1/WE HEREBY AUTHORIZE
COLONIAL PROPERTY MANAGEMENT, INC. TO OBTAIN A CREDIT REPORT AND CHECK REFERENCES GIVEN IN THIS
APPLICATION FOR THE PURPOSE OF EVALUATING THIS APPLICATION. A CHARGE OF $20.00 WILL ACCOMPANY

THIS APPLICATION FOR THE PURPOSE OF SECURING A CREDIT REPORT AND OTHER HANDLING
CHARGES.

SIGNED ______________________________________________ DATE _______________________________

SIGNED ______________________________________________ DATE _______________________________
A DEPOSIT OF $ ______________________________ IS HEREBY ACKNOWLEDGED WITH THIS APPLICATION.
THE APPLICATION FEE OF $20.00 PAID BY: CHECK OR CASH DATE PAID _____________________________
THIS APPLICATION FEE & FORM RECEIVED BY _________________________________________________________
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Copy of Drivers License attached

Yes _______

No ______

Revised 6/02/2010