Apply Online – JnY Realty Holdings, LLC. Belleville IL Property Rentals & Management

Applicant

Personal Information

Name *

Date of Birth *

Social Security # *

Drivers License # *

Phone Number *

Mobile Number *

Email Address *

Time at Current Address *

Current Street Address *

City *

State *

Zip Code *

Landlord/Agent Name *

Landlord/Agent Phone *

Rent/Mortgage Amount *

Radio Buttons

Own

Rent

Previous Street Address

Previous City

Previous State

Previous Zip Code

Landlord/Agent Name

Landlord/Agent Phone

Rent/Mortgage Amount

Radio Buttons

Own

Rent

List All Occupant Names & Ages

List All Vehicles (Make, Model, Year, Color, License Plate #)

Employment Information

Current Employer *

Phone *

Position *

Length of Employment *

Street Address *

City *

State *

Zip Code *

Manager Name *

Manager Phone *

Hourly Salary *

Annual Income *

Co-Applicant (if married)

Personal Information

Name

Date of Birth

Social Security #

Drivers License #

Phone Number

Mobile Number

Email Address

Time at Current Address

Current Street Address

City

State

Zip Code

Landlord/Agent Name

Landlord/Agent Phone

Rent/Mortgage Amount

Radio Buttons

Own

Rent

Previous Street Address

Previous City

Previous State

Previous Zip Code

Landlord/Agent Name

Landlord/Agent Phone

Rent/Mortgage Amount

Radio Buttons

Own

Rent

Employment Information

Current Employer

Phone

Position

Length of Employment

Street Address

City

State

Zip Code

Manager Name

Manager Phone

Hourly Salary

Annual Income

Emergency Contact

Name (Person who does not reside with you) *

Phone *

Relationship *

Street Address *

City *

State *

Zip Code *

Personal & Professional References

Reference Name *

Phone *

Street Address *

City *

State *

Zip Code *

Reference Name *

Phone *

Street Address *

City *

State *

Zip Code *

Credit References

Bank/Branch

Loan Account Number

Checking Account Number

Savings Account Number

Additional Information

Why are you leaving your current residence?

Have you given legal notice?

Renters Insurance Provider

How did you find out about our rental?

Do you intend to use a waterbed at this location?

Yes

No

Smoking

I understand there is no smoking within 15 feet of the building

Have you been evicted in the last 5 years?

Yes

No

If Yes, list landlord and circumstances of eviction:

Have you ever filed a petition in bankruptcy?

Yes

No

If Yes, please describe details of bankruptcy:

Have you ever been convicted of a felony or misdemeanor??

Yes

No

If Yes, please explain conviction:

This is a rental application only and does not constitute acceptance of the applicant as a tenant, nor a rental agreement or tenancy relationship between the parties. A separate rental application is to be completed by each unmarried adult. Inaccurate or falsified information will be grounds for denial of the application or eviction from the premises. Applicants may be deemed ineligible if rent exceeds thirty-three percent (33%) of monthly gross income.

NON-REFUNDABLE APPLICATION FEE: $25 for each applicant.

This non-refundable application fee is not a deposit and does not apply toward rent, unless specified, should the applicant, after the qualifying process, be accepted as a tenant. The application fee is to cover the costs of qualifying the applicant as a prospective tenant.

APPLICATION FEE MUST BE PAID IN CASH, CREDIT CARD, $CASHAPP, OR VALID POSTAL MONEY ORDER.

A portion of the application fee is being applied to credit and criminal background reports, which provide information relating to your prior credit/rental history. The name and address of the service utilized is: [NAME OF CREDIT AGENCY]. The costs of the reports typically range from $15 to $25, as of January 1, 2003, per applicant, unless applicants are married. You are entitled, by law, to dispute the accuracy of any information provided on the reports.

Authority for Release of Information: This release will constitute my/our consent and authority to examine statements and information regarding my/our background.

I/We authorize you to contact my/our present and previous landlords, law enforcement agencies, credit agencies, and other references listed above.
I/We hereby authorize the release of any and all data or records to JnY REALTY HOLDINGS GROUP, LLC. This authorization is given in connection with a financial, criminal, and previous rental history investigation being conducted relative to my/our application for credit dealing with rental property.
I/We acknowledge that my/our application fee will not be refunded if the Landlord does not accept this application.
I/We understand that I/we acquire no rights in a rental unit until I/we sign a Rental Agreement on the rental unit (noted above) to be held in accordance with the Rental Agreement.
I/We declare the foregoing to be true under penalty of perjury.
I/We agree that the Landlord may terminate any agreement entered in reliance on any misstatement made above.
I/We understand that my/our rent will commence upon the date of approval of my/our rental application and the availability of the dwelling, whichever occurs later.
I/We acknowledge that I/we have been provided with a Notice of Reasonable Accommodation.

E-Signature *

Tenant First Name, Last Name

E-Signature:

Co-Tenant First Name, Last Name