Application for Residential Lease
Please print out form, fill out and fax to (212) 941-1796.
| Date: | Social Sec#: _____-___-_____ | ||
| Name: | |||
| Address: | |||
| City: | State: | Zip: | |
| Hm Phone: | Fax: | ||
| Wk Phone: | |||
| Second Applicant | Social Sec#: _____-___-_____ | ||
| Name: | |||
| Address: | |||
| City: | State: | Zip: | |
| Hm Phone: | Fax: | ||
| Wk Phone: | |||
| Landlord's Name: | Phone: |
| Landlord's Address: | |
| Previous Address: | |
| Rent Paid: | Length of Tenancy: |
| Occupation: | Current Salary: |
| Co Name & Add: | # of yrs working: |
| Dept Head Name: | Phone: |
| Bank Name: | Bank Acct #: |
| Bank Address: | |
| Bank Name: | Bank Acct #: |
| Bank Address: | |
| Charge Accounts: | |
| Emergency Contact:: | Phone: |
| Emergency Contact Address: | |
| Number of Persons to Occupy Apartment: | |
| Any Pets (specify dog breed and size): | |
| Broker Name: | Phone: |
| Broker Co: | Fax: |
I (print name)_____________________hereby authorize Ventilaire Realty Co. to obtain a credit report and Landlord and Tenant search from a recognized credit reporting service. I hereby warrant that all of the above is true. It is understood that this application shall be subject to the Landlord's approval, and any deposit accepted with this application shall be returned to the applicant only upon the Landlord's rejection of this application. This is not a lease.
Print Name_______________________________________
Signature of Applicant_______________________________
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©1999-2011 Ventilaire® Realty Corp. All rights reserved PO Box 692, New York, NY 10013-0692 | Fax: (212) 941-1796 | rentals@canalspace.com Space on Canal Street since 1947 |