Cumberland Construction Corporation

Cumbererland Construction Corporation

Steeplechase Apartments Rental Application

Please fill out the application below and our friendly on-site manager
will contact you very soon.
Thank you for your intrest in Steeplechase Apartments

Phone: 419-867-8672
E mail: sca@cumberlandconstruction.com

General Information
*Lease In Name Of:
*Birth Date:
*Phone:
*Present Address:
*City:
*State:
*Zip:
*Present Rent:
*Present Landlord:
*Landlord Phone:
*Previous Address:
*City:
*State:
*Zip:
*Rental Rate:
*Reason For Moving:
*Have you ever been asked to move? If yes, explain:
Persons who will occupy apartment (including yourself)
Name
Relationship
Birth date
Employment
*Present Employer:
*From:
*Address:
*Position:
*Phone:
*Income:
Previous Employer:
From:
 To:
Address:
Position:
Phone:
  
Other Income Sources:
Amount:
References
References:
Motor Vehicles
Make:
Year:
License#:
Color:
Make:
Year:
License#:
Color:
In Event Of Emergency, Contact:
*Name:
*Relationship:
*Address:
*Phone:

I/We understand a criminal history, a credit history, income verification and past rental or mortgage history are included with this application.

Receipt of $35.00 Application Fee is hereby acknowledged. This Application Fee is NOT refundable.

I/We hereby authorize any person or company to supply Steeplechase Apartments with any info requested concerning me/us. I/We understand that misrepresentation or concealment relative to any of the above facts will at Lessor’s option, void my/our rights under any agreements entered into for the rental of the premises being applied for.