Apartment Application Form
Please type in the form areas and click the submit button at the bottom of the page. Please note all fields must have a response or
the form will not submit.
Name
Current Address
Driver's Licence #
Cell Phone #
Date of Birth
Social Security #
Current Landlord's Name and Address
Email
How Long at This Address?
Landlord's Telephone
Current Monthly Rent
Monthly Income
Previous Address
Current Employer
Employers Address
List All Pets
Make and color of Auto
Have you ever been evicted from a rental property? (please check Y/N)
Yes
No
Have you ever been to Landlord/Tenant court? (please check Y/N)
No
Yes
Name and phone of nearest relative
Apartment you are interested in
CERTIFICATION: I understand that the above information is confidential.  I hereby certify that I have examined this application and the above information
made here is to the best of my knowledge and belief a true and complete application made in good faith. I hereby give my permission to have any of the
statements made or information provided on this application verified by a credit reporting agency or other similar entity or by the landlord, mortgagees,
employers,or other sources identified on this application. I further understand the managements review and assessment of this application may include
acquisition of my criminal history record, if any. I hereby give Eagle Management of Ypsilanti permission to acquire such information solely for the purpose of
reviewing or assessing this application.
Please type your name
Applicant Electronic Signature
Date