Rental Application

Please fill out this form as completely as you can, any questions left unanswered may lead to an application rejection. If you are a co-applicant for another person, please give the name of the Primary Applicant in the appropriate field.

Step 1 of 7 - Identification Information

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Name*
PrefixFirstLastSuffix
Middle Name*
Email*
Enter EmailConfirm Email
Date of Birth*
Primary Phone*
Secondary Phone
Address*
Street AddressAddress Line 2CityStateZip Code
Social Security Number
License/ID Number*

Do you currently...*
Landlord Name
Landlord Phone
Ever been evicted?*
Eviction Detailes

Are you currently employed?*
Company Name
Supevisor Name
FirstLast
Supevisor Phone
Emplyment Length
Monthly Income*

Ever been convicted of a crime?*
Criminal History

Reference 1 Name*
FirstLast
Reference 1 Phone*
Reference 2 Name*
FirstLast
Reference 2 Phone*

Move In Date*
Number of Rooms*
Do you have a pet?*
Pets
- Cat
- Caged Reptile
- Caged Rodent
- Aquarium
- Small Dog (Less then 7 LBS)
- Medium Dog (7 - 20 LBS)
- Large Dog (20 - 50 LBS)
- Extra Large Dog (50 + LBS)
Total Number of Pets

I represent that the information provided in this application is true, complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information is grounds for eviction and/or application denial.

I understand that this application is not a rental agreement and that this application in no way creates any obligation on the part of the landlord, River District Apartments LLC., Mark Mercer, or any of its agents.

By submitting this application, I agree to allow River District Apartments to conduct a background check.
Signature*
Comments
This field is for validation purposes and should be left unchanged.