149 West Susquehanna Avenue, Philadelphia, PA (215)

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1 Our Apartments and Townhouses are located in the Norris Square Neighborhood. They include a refrigerator and stove. The renter of an apartment is responsible for rent and all utilities except water. The renter (of a house is responsible for all utilities Nuestros-Apartamentos y cases estan localizados en la vecindario de Norris Square. Los apartamentos incluyen una nevera y Ica estufa. El inquilino de un aparlamento es responsable del alquiler, del gas, y de,'as cuentas electricas. El isquilino de una casa es responsable del alquiler, del gas,del agua, y de las cuentas electricas. What are you applying for?/ Cual unidad solicita usted? You Must provide all the documents mentioned below from all the family members that will be living in the unit. Usted debe proporcionar todos los documentos mencionaolos abajo de todos los miembros de la familia que estartin viviendo en to unidad. Date received -- front desk will stamp the application La fecha recibida la recepcionista pondrei la fecha recibida en la aplicacion Copies of Social Security Cards for all household members. Las copias de Tarjetas Sociales de Seguridad para todos miembros de la casa Copies of Birth Certificates for all household members Las copias de Certificados de Nacimiento para todos inietnbros de la case Picture Identification far all applicants ages 18 & older Example: Driver s License, State issued Non-Driver s License, Passport Retratos de identvicacion de todos solicitantes 18 anos de edad y mas mayor For ejemplo: Su Licencia, o el Pasaporte Proof of Income of all household members (for the past month) Example: Pay Stubs, copy of award letter, Social Security Letter La prueba de ingresos de todos miembros de la casa,(por el mes pasado) Por ejemplo: Talonarlos de Paga, la copia de carta de premio, Carta de Social de Seguridad Proof of tenacy (lease) if applicable If you don't have a lease please bring a letter from your landlord including landlord's name, address and phone number Prueba de Arrendamiento (contrato de arrendamiento) de donde vives ahora Si no tienes contrato de arrendamiento favor de traer una carta firmada. por el dueno- de la costa, Favor de incluir el nombre. direccion y el telefono del dueno de la casa Make sure application is completely filled and signed by applicants ages 18 & older Cerciorese que la aplicacion se Ilena completamente y es firmada por los,solicitantes do 18 anos y mas mayor, Please bring all the required information with you when you return the application packet. If your application is missing anything it will be dented. Traiga por favor toda Ia inforrnacion requerida con usted cuando usted vuelve paquete de la aplicacion. Si su aplicacion no tiene toda la informacion requerida su applicacion no sera procesada

2 Applicants Full Name Nombre De Aplicante Social Security # # De Seguro Social Co-Applicant s Full Name Nombre de Co-Applicante Social Security # # De Seguro Social Current Address Direccion Presente City Cuidad State Estado Zip Code Codigo Telephone Numero De Telefono List the head of household and other members who will be living in the unit. the relationship of each member to the head Pon so nombre y los nombres de todas las personas que van a vivir con usted en la unidad. tambien pon el relacion de ellos a usted # of Member Full Name Nombre Relationship Relacion Date Of Birth Fecha De Nacimiento Age Edad Sex Sexo Social Security Seguro Social Race of Head of Household Raza De Applicante For Statistical Purposes Only / Para Propocito Estadistico Solamente White Black American Indian Asian Ethnicity of Head of Household Etnia de Applicante Hispanic Non-Hispanic Are all the members of your household full-time students? Son todos los miembros de la casa estudiantes de jornada complete? Does anyone live with you now that is not listed below? Hay alguien que vive con usted ahora que no esta listo arriba? If please explain Si si, explica por favor Do you plan to have anyone living with you in the future who is not listed above? Planea usted tener otra persona viviendo con usted en el future que no se lista arriba? If please explain Si si, explica por favor

3 Is there a member in the household who needs a mobility impaired unit? Hay un miembro en la casa que necesita una unidad que sea para alquien que tenga una debilidad? How long have you lived at your address? Tiempo vivido en su hogar? Rent? Cantidad del alquiler Who was your landlord? Nombre de Arrendador Where were they located? Direccion del Arrendador Where did you previously live? Direccion Anterior How long did you live at the address? Tiempo Vivido en su hogar Rent? Cantidad del alquiler Who was your landlord? Nombre de Arrendador Where were they located? Direccion del Arrendador How many people live with you now? Cuantas personas viven con usted ahora How many bedrooms do you have? Cuantos curators de dormitorio Do you wish to move? Quiere usted mover? If, Why? Si, si entonces por que? Are you being evicted? Te estan expulsando de la casa? If please explain Si si, explica por favor What utilities do you pay? Que utilidades paga usted? Are you now living in a government subsidized unit (Public Housing, Section8) Vive usted en un unidad subvencionada por el gobierno? Are you now living in a government section 8 assistance? Esta uste o va usted recibir assistencia de Seccion 8? Please give references who are not family members / Por favor escribe tres personas de referencia: Name / Nombre Address / Direccion Telephone / Telefono

4 Telephone Telefono Position Posicion Co-Applicants Current Employer Empleo Presente del Co-Applicante Salary Salario How long have you been working here? Tiempo que lleva de trabajo Hourly/Weekly/Bi-Weekly Por hora/semana/quincinal Address Direccion State Estado Zip Code Codigo Telephone Telefono Position Posicion Salary Salario How long have you been working here? Tiempo que lleva de trabajo Hourly/Weekly/Bi-Weekly Por hora/semana/quincinal Please answer each of the following questions. For each answer provide details in the chart below. Conteste por favor las preguntas siguientes. Paracada si repuesta proporciona detailes en el mapa abajo Is any member of your household employed, full time, part time, seasonally? Es empleado cualquier meimbro de su casa, tiempo replete, por horas, estacionamente? Does any member expect to work for any period during the next twelve months? Espera cualquier meimbro para trabajar para cualquier period durante el luego doce meses? Does any member work for someone who pays cash? Trabaja cualquier miembro para alguien que paga ellos cambia? Any member on leave of absence due to lay-off, medical, maternity, or military leave? Cualquier miembro en el licenia debido si paro involuntario, medico, la maternidad o la hoja del ejercito? Does any member of your household now receive, or expect to receive unemployment benefits? Ahora recibe cualquier miembro de su casa, o espera recibir los beneficios del desempleo? Does any member of your household now receive, or expect to receive child support? Ahora recibe cualquier meimbro de su familia, o espera recibir apoyo de nino? Is any member of your household receiving alimony payments? Recibe cualquier miembro de su casa los pagos de pension? Does any member of your household receive welfare assistance? Recibe cualquier miembro de su casa ayuda de bienestar? Does any member of your household receive Social Security? Recibe cualquier miembro de su casa la Seguridad Social? Does any member of your household receive income from pension or annuity? Recibe cualquier miembro de su casa los ingresos de pension o la anualidad? Does any member of your household receive regular cash contributions from individuals not living in unit? Recibe cualquier miembro de su casa contribuciones reulares de cambio de individuos que no viven en la unidad? Does any member from your household receive income from assets including interest on checking or savings accounts, or the rental of properties? Recibe cualquier miembro de su casa los ingresos de ventajas inclusive el interes a cuentas de verificar o ohorros, o a la renta de propiedades?

5 For each type of income that your household receives, give the source of the income and the amount of income that can be expected from that source during the next 12 months Para cada tipo de ingresos que su casa recibe, de la fuente de los ingresos y la cantidad de ingresos que se pueden esperar de esa fuente durante los proximos 12 meses. Family Members Name Los Miembros de la familia Source of Income or Type of income Source de ingresos o tipo de ingresos Monthly Income Ingresos Mensuales Annual Income Ingresos Anuales Waiver of Privacy / Credit I, SS# Hereby waive the right of privacy between myself and Norris Square Civic Association (NSCA), Norris Square Limited Partnership (NSLP) and/or Borinquen Federal Credit Union on order to give the above parties the opportunity to discuss with relevant parties, information regarding my credit report and the landlord history. I therefore, authorize NSCA/NSLP to request a credit report on my behalf to discuss the information with the property Manager of NSCA/NSLP. Yo, SS# Por este medio cedo mis derechos de privacidad entre yo y La Associacion Civica de Norris Square (NSCA), Norris Square Limited Partnership (NSLP) y/o Boriquen Federal Credit Union para de esta manera darle a NSCA/NSLP la opportunidad de discutir informacion de mi historial de credito y referencias de aarendamiento. Con mi firma autorizo a NSCA/NSLP que haga una investigacion de mi credito Applicant Signature / Firma de Solicitante Co-Applicant Signature / Co-Firma de Solicitante

6 Monthly Household Budget Monthly Income Net Income $ Spouse Net Income $ Other Household Income $ Total Household Income $ Monthly Living Expenses Amount Paid Monthly Rent/Mortgage $ Second Mortgage $ Taxes $ Homeowner s/renter s Insurance $ Fee-Association/Condo/Alarm $ Loans / Credit Cards $ Student Loans $ Electric $ Gas $ Water $ Cable / Movies / Videos $ Phone $ Cellular Phone / Beeper $ Food / Groceries $ Lunch / Breaks $ Personal Items / Toiletries $ Grooming / Hair / Nail $ Laundry /Dry Cleaning $ New Clothing Purchases $ Infant Supplies $ Day Care / Baby Sitter $ Tuition / School Supplies $ Support / Alimony $ Allowances / Dependents $ Car Payment $ Car Insurance $ Gas $ Public Transportation $ Tolls / Parking $ Doctors $ /Dental/Therapy/Vision/Prescription Dinners / Fast Food $ Cigarettes / Tobacco $ Alcohol $ Lottery $ Pet Food/Supplies/News Paper $ Donations / Religious / Other $ Gifts / Holidays / Birthday s $ Dues / Clubs / Hobbies / On-line $ Vacation / Time Share $ Savings $ Total Monthly Expenses $ Total Monthly Income $ Residual Income $ Savings Available $ Client Signature Counselor s Signature Date

7 Applicant Name First, Middle, Last Social Security Number (XXX-XX-XXXX) Current Address City, State, Zip Code Previous Address City, State, Zip Code Birth Date MM/DD/YYYY Work Number Extension Home Phone Number I Hereby grant the above apartment/landlord/realtor, whichever is applicable and its designee, Landlord Protect, a credit reporting agency, the right to process this credit application for the purpose of obtaining a rental lease. In compliance with FAIR CREDIT REPORTING ACT, this notice is to inform you that the processing of this application includes but is not limited to making inquiries deemed necessary to verify the accuracy of the information herein, including procuring consumer reports from consumer reporting agencies, obtaining credit information from other credit institutions and criminal background checks from appropriate law enforcement agencies. You have the right to make a written request within a reasonable period of time to receive additional information about the nature of this investigation. The undersigned agrees that this application shall remain the property of the apartment complex, landlord or realtor regardless if rental lease is granted. Applicant Signature Below must be completed by authorized personnel for this application to be processed Please add any additional comments you wish to know concerning this application RRIS SQUARE 7 Digit Account Number Company Name Processor s Name P.O BOX 521 ABSECON, NJ PHONE (800) FAX (800) Thank you for choosing Landlord Protect!

This application expires 6 months after submitted. Esta aplicación vence 6 meses después de sometida.

This application expires 6 months after submitted. Esta aplicación vence 6 meses después de sometida. Our Apartments and Townhouses are located in the Norris Square Neighborhood. They include a refrigerator and stove. The renter of an apartment is responsible for rent and all utilities except water. The

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