Sterling Real Estate Management LLC

RENTAL APPLICATION

Phone (516) 482-4820 FAX Back To : (516) 482-1212

Building Address: ______________________________________
Application For Apt:________ Monthly Rent____________ Date of Application____________ Lease Start Date______________

Full Name_______________________________________*Date of Birth ____ -- _____---________ S.S.#______-____ -_____

E-Mail:_____________________Cell Phone#( )_____________ Home#( )_______________ Work #( )______________
In Case of Emergency: Contact:_______________________________Telephone( )________________________
___________________________________________________________________________
Other Residents
1._________________________________Relationship Age_if under 18__________
2._________________________________Relationship Age_if under 18__________
Do you have any pets?_______ Please specify___________________

RESIDENTIAL HISTORY
Address____________________________________________ City:__________________State:_________Zip Code:_________
Telephone________________________________Length here:______________Reason Moving___________________________
Monthly Rent $__________________Landlord__________________________________Landlord Telephone_________________
Address_____________________________________________City:___________________State:________Zip Code:_________
Length here:____________Monthly Rent $___________Landlord_____________________Landlord Telephone_____________

EMPLOYMENT INFORMATION

Employer________________________________________Supervisor_________________________Start Date:_______________
Employer’s Address______________________________________________Telephone________________________________
Annual Income $__________________ Position ____________________ Bonus $___________ Housing Allowance $_________
Previous Employer________________________________Supervisor_________________________Dates___________________
Previous Employer’s Address______________________________________Telephone_________________________
Annual Income $________________ Position ____________________ Bonus $_____________ Housing Allowance $_________

BANKING AND PROFESSIONAL REFERENCES

Bank_____________________________Address_______________________________
Banking Officer_________________________Telephone( )___________________
Checking Account #_____________________Savings Account #________________________
Attorney_______________________________Telephone( )___________________
Accountant____________________________ Telephone( )___________________

AUTHORIZATION
The Owner will in no event be bound nor will possession be given, unless and until a lease executed by the Owner has been delivered to the Tenant. The
applicant and his references must be satisfactory to the Owner. No representations or agreements by agents, brokers or others are binding on the Owner or
on any Agent unless included in the written lease proposed to be executed. I hereby warrant that all my representations set forth above are true. I further
represent that I am not renting a room or an apartment under any other name, nor have I ever been dispossessed from any apartment, nor am I now being
dispossessed. I represent that I am over 18 years of age. I authorize the verification of the above-referenced information and its release to the Owner,
Managing Agent or other parties connected with the lease contemplated herein. I authorize a credit search by name and social security number, at this time,
and at anytime during my tenancy. I will present any other information required by the Owner or Managing Agent in connection with the lease contemplated
herein.
I understand that all credit fees are non-refundable once this application is submitted to the Owner.

Signature_____________________________________________________________ Date_________________________________________
*Date of birth is being requested only for the purpose of identification in obtaining accurate retrieval of records, and will not be used for
discriminatory purposes.