JOUETT SQUARE TOWNHOMES 301 LYDE AVENUE LOUISA, VA 23093 1-540-967-9643 THERE IS A $25.00 NON- REFUNDABLE APPLICATION FEE FOR THE PROCESSING OF THIS APPLICATION. PLEASE MAIL TO THE ABOVE ADDRESS WITH YOUR MONEY ORDER. APPLYING FOR ___ 2 BEDROOM ___ 3 BEDROOM ___ 4 BEDROOM ___ RENTAL HOUSE MOVE IN DATE _________________ PHONE NUMBER __________________ LIST ALL PERSONS TO OCCUPY THE PREMISES: _____________________________________________________________________________________ NAME AGE RELATIONSHIP _____________________________________________________________________________________ NAME AGE RELATIONSHIP _____________________________________________________________________________________ NAME AGE RELATIONSHIP _____________________________________________________________________________________ NAME AGE RELATIONSHIP _____________________________________________________________________________________ NAME AGE RELATIONSHIP PETS TO OCCUPY THE PREMISES: TYPE _____________ WEIGHT ___________ TYPE _____________ WEIGHT ___________ HAVE YOU EVER RENTED FROM COLONIAL COURT / HAVENS PROPERTIES BEFORE? _______________ IF SO _______________________________________________________________________________ ADDRESS DATE LEASE TERMINATED DID YOU RECEIVE A REFUND NAME OF PERSON APPLYING FOR APARTMENT: _____________________________________________________________________________________ LAST FIRST MIDDLE MADIEN DATE OF BIRTH _________________ SOCIAL SECURITY NUMBER ____________________ PRESENT ADDRESS _____________________________________________________________________ PRESENT LANDLORD ____________________________________________________________________ NAME ADDRESS PHONE NUMBER PRESENT MONTHLY PAYMENT __________ LENGTH OF OCCUPANCY ____________________ PRESENT EMPLOYER ____________________________________________________________________ NAME ADDRESS PHONE NUMBER LENGTH OF EMPLOYMENT ___________________ SUPERVISOR'S NAME ______________________ MONTHLY INCOME BEFORE TAXES ______________ POSITION _______________________________ CAR: ________________________________________________________________________________ MAKE MODEL COLOR LICENSE PLATE NUMBER ________________________________________________________________________________ MAKE MODEL COLOR LICENSE PLATE NUMBER CREDIT REFERENCES: NAME ACCOUNT NUMBER MONTHLY TERMS ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ PERSONAL REFERENCES: NAME ADDRESS PHONE NUMBER YEARS KNOW ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ I TESTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I GIVE MY CONSENT FOR JOUETT SQUARE TOWNHOMES/ HAVENS PROPERTIES TO OBTAIN THE NECESSARY INFORMATION REQUIRED IN ORDER TO MAKE A DETERMINATION AS TO MY ACCEPTANCE. I UNDERSTAND