130 Westchester Square Bronx NY 10461

130 Westchester Square Bronx NY 10461 926 Allerton Sve Bronx NY 10469

Applicant Information

Last First M.I: Name: Name: Current Street Addess/Apt No.: City, State, Zip:

Social Sec. No: ( ) Home Phone No.: Date of Birth: ( ) Cell Phone No.: Driver’s License No: ( ) Work Phone No.: Email Address:

If Guarantor Application, Describe relationship to Applicant

Other Occupants

Name: Date of Birth: Relationship:

Residency Information

Curent Status: Rent Co-op/Condo Homeowner Other:

Landlord Name: Landlord ( ) Phone No.: Full Address: Dates of Residency: Reason for leaving: Monthly $ Rent: Current Employment (if less than 3 years, also complete next section)

Current Status: Employed Self-Employed Retired Student Unemployed

Company/ School Supervisor’s Name: Street Address Supervisor’s ( ) Phone No.: City, State, Zip:

Occupation: Gross Annual $ Salary: Responsibilities: Dates of Employment:

Previous Employment

Compamy/ School: Supervisor’s Name: Street Addres: Supervisor”s ( ) Phone No.: City, State, Zip: Occupation: Gross Annual $ Salary: Responsibilities: Dates of Employment Pets

Do you currently Own or Plan To YES NO Description: Keep pets in the apartment? (ATTACH PHOTO) Questionnair

Have you ever rented or resided in YES NO If yes, address and dates: one of our apartments before? Would you like to live on a YE NO explain: particular floor? S Have you ever gone to Landlord/ YES NO explain: Tenant Court? Would you prefer a building or YES NO explian: Private house? Desired location/ Public YES NO explain: Transportation? Do you have big / a lot of YES NO explain: furniture? Do you have a housing Program? YES NO explain:

Are you looking to move within YES NO explain: this month? YES NO explain: Disclosure, Agreement & Consent

 I authorize Future Homes Realty to conduct all necessary background checks concerning my / our application and to verify references I / We have provided: Included, but not limited to, credit reports, civil or criminal actions,rental hiatory, employment/ salary details, police ans vehicle records, and any other relevent information; and I release Landlord, its employees and agents from all liability for any damage whatsoever incurring furnishing or cbtaining such information. I agree to pay a non-refundable application fee retained by the Landlord as the ageed compensation for credit investigation, processing and verification of the application, other expenses and / or loss of rent and the landlord shall have no further obligation ehich the Landlord or his agent may reject.

 I declare that all information listed on this application is true and correct and that providing false information is cause to be rejecte as a tenant and / or evicted.

 I acknowlegde that you will require the same information for all adults living in the apartment. Failure to provide this information is cause for this application to be rejected.

 I acknowledge that no lease will become effective untill management approves this application and has viewed a positive credit report.

Signature: Date:

Title VII of CIVIL RIGHT ACT of 1966 makes no discrimination based upon race, religion, or national origin illegal with the rental of most housing in connection with the rental of most housing. The Federal Agency which administers with this law concerning this company: Equal Credit Opportunity, Federal Trade Commisssion, Washington, D.C. 20580