Rental Application & Questionnaire

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Cristina Lagos Ríos
hace 7 años
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1 Instructions/Instrucciones: Rental Application & Questionnaire 1. Please complete application in full to the best of your knowledge (Favor de llenar esta applicacion por completo y a lo mejor de su conocimiento). 2. All household members over the age of 18 must sign this application form (Todos los miembros de su familia sobre la edad de 18 deberan firmar esta applicacion). 3. Only submit ONE application by household. (Solo someter UNA applicacion por familia) 1. Inquiry Information (Informacion de busqueda) Desired Apartment Size (Tamaño de Apartamento deseado) Studio 1 Bedroom 2 Bedroom 3 Bedroom Location Desired (Locacion deseada) Manhattan Bronx Queens Brooklyn Other 2. Household Information (Informacion Familiar): 3. *Head of Household (Cabeza de Familia): Street Address (Direccion): City (Ciudad): State (Estado): Zip Code (Codigo Postal): How long have you lived at the present address? Hace cuanto tiempo usted reside en esta direccion? Years (Años): Months (Meses): *Household Composition (Composicion Familiar): List all persons that will be residing in the apartment you are applying for starting with yourself. (Enumere a todos los miembros de su familia que residiran en el apartamento por el que esta applicando, empezando con si mismo) Relationship : Date of Birth: Social Security #: Occupation (Relacion) (Fecha de (# de Seguro Social) (Ocupacion) Nacimiento)

2 Do you anticipate any changes to your family composition in the next 12 months? Anticipa usted algun cambio en su composicion familiar en los siguientes 12 meses? YES NO Any household members are temporarily absent? Algun miembro de su familia esta temporalmente ausente? YES NO 4. Income Information (Informacion de Ingreso Economico): List all income for each household member including employment, self- employment, child support, alimony, social security, public assistance, unemployment, etc. ( Liste todos los ingresos para cada miembro de la familia inlcuyendo empleo, empleo por si mismo, Apoyo a la infancia, Seguro Social, Asistencia Publica, Desempleo, etc) Source of Income (Fuente de Ingreso) Annual Income (Ingreso Annual) 5. Asset Information (Informacion de bienes/valores) List all assets for all household members including checking, savings and money market accounts, stocks/bonds, 40K, 503B, credit unions, life policies, etc. (Liste los bienes de todos los miembros de la familia incluyendo cuenta de chequera, ahorros, money market, valores de Mercado, 401K, 503B, polizas de seguro de vida, etc.) Asset Type: Institution where asset is held: Asset Value (Tipo de bien o valor) (Institucion done se mantiene sus bienes) (Valor de sus bienes)

3 Have you disposed of any assets for less than fair market value in the past 12 months? Se ha usteds desecho de bienes por menos de su valor del Mercado en los ultimos 12 meses? YES NO Are any assets held jointly with other persons than the one on this application? Sostiene usted bienes en comun con personas diferentes de las mencionadas en esta application? YES NO Have you filed for Chaper 7 Bankrutpcy in the past 10 years? Ha usted archivado Chapetr 7 Banruptcy en los ultimos 10 años? YES NO 6. Current Rental Information. (Informacion de alquiler actual): Landlord (Casero): Office Address (Officina de Arrendamiento): Phone # (# de Telefono): Current Monthy Rent Amount (Monto de Renta Actual): $ Are you a Section 8 voucher holder? Es usted titular de un voucher de Seccion 8: YES NO If so, for how many bedrooms. (Si es asi, por cuantas habitaciones) Reason to Move (Razon de Mudanza): Living with Relatives (Viviendo con familiares) Rent is too High (Alquiler muy alto) Increase of Family Size (Incremento en tamano de familia) Area not desirable (Area no deseable) Bad Housing Conditions (Malas condiciones de apt.) Living in Shelter (Viviendo en un Shelter) Other (Otro) 7. How did you hear from us?? Como escucho sobre nosotros?: Newspaper Periodico Friend Amigo Web site/online Pagina Web Sign on Building Letrero en Edificio Other (Otro)

4 Credit Authorization Autorizacion de Credito I / We hereby authorize C. Perdomo & Associates, LLC to use any consumer reporting agency, credit bureau or other investigation agencies employed by such, to investigate all information and data obtained from me or from any other person pertaining to my employment history, credit, prior tenancies, character, general reputation personal characteristics and mode of living. To obtain a consumer report and such other credit information which may result thereby, and to disclose and furnish such information to the owner/agent listed above in support of this application. I have been advised that I have the right, under section 606b of Fair Housing Reporting Act, to make a written request, with reasonable time for a complete and accurate disclosure of the nature and scope of investigation. Yo / Nosotros autorizamos C. Perdomo & Associates, LLC a utilizar cualquier agencia de reporte del consumidor, buro de credito o otras agencias de investigacion empleados para investigar toda mi informacion y data como la de las personas pertenientes a esta applicacion con respecto a mi historial de trabajo, credito, arrendamientos pasados, character en general, reputacion personal, caracterisitcas y modos de vida. A obterner un reporte del consumidor y otra informacion de credito para proveer al dueno / agente mencionado anteriormente en soporte a esta applicacion. He sido sugerido, bajo la seccion 606b de Fair Housing Report act, ha hacer, con tiempo razonable, un pedido por escrito una descripcion exacta de la naturaleza del campo de investigacion. I / We certify that all information provided in this application is true and complete to the best of my/our knowledge. I I / We understand that any false or misleading information given in my application and interview or any other company record may result in denial of tenancy. I/We also understand that my occupancy is contingent on meeting managements residency selection criteria and requirements. Yo/Nosotros certificamos que toda la informacion proveida en esta application es verdadera y complete a lo major de mi entendimiendo. Yo / Nosotros entendemos que cualquier informacion falsa o deceptive dad en esta aplicacion, entrevista o cualquier record de esta compania puede resultar en la desaprobacion de su aplicacion. Yo / Nosotros tambien entendemos que mi arrendamiento es contingente a la criteria y requerimientos del arrendador. Head of Household Applicant # 2 Applicant # 3 Applicant # 4

5 Client Agreement Name Address Home #: Cell #: Name of current employer: Occupation: Desired move in Number of Occupants: Number of Bedrooms desired: Location desired Desired price range YOU HAVE ENGAGED C.PERDOMO & ASSOCIATES TO ACT AS YOUR BROKER TO ASSIST YOU IN LOCATING AND RENTING AN APARTMENT. IN CONSIDERATION FOR SAME, IF YOU, OR ANYONE ACTING ON YOUR BEHALF, RENT AN APARTMENT TO WHICH C.PERDOMO & ASSOCIATES LLC DIRECTED YOU, YOU AGREE TO PAY C.PERDOMO & ASSOCIATES A FEE OF: 15% OF THE FIRST YEARS ANNUAL RENT FOR A LEASE TERM OF ONE (1) YEAR. THE COMMISSION IS DUE AND EARNED AND SHALL BE PAID TO US WHEN YOU EXECUTE THE LEASE/SUBLEASE AND IS REFUNDABLE ONLY IF (1) THE LANDLORD/SUBLESSOR FAILS TO EXECUTE THE LEASE OR (2) IN A COOPERTATIVE BUILDING, THE BUILDING REJECTS YOUR APPLICATION THROUGH NO FAULT OF YOUR OWN OR THE BUILDING EXERCISES A RIGHT OF FIRST REFUSAL. IF THE LEASE IS NOT EXECUTED, WE SHALL ALSO RETURN ANY SECURITY DEPOSIT OR RENT CHECK IN OUR POSSESSION. WITH RESPECT TO ALL OPEN LISTING AND OTHER BROKER S EXCLUSIVE LISTING, WE REPRESENT YOU, THE PROSPECT TENANT. WITH RESPECT TO OUR EXCLUSIVE LISTING, WE REPRESENT THE OWNER. YOU UNDERSTAND THE LANDLORD/SUBLESSOR IS NOT OBLIGATED TO YOU IN ANY WAY UNLESS A LEASE IS FULLY EXECUTED OR A SUBLEASE IS DELIVERED TO YOU. IT IS AGREED THAT ANY AGREEMENT ENTERED INTO WITH RESPECT TO LEASING AN APARTMENT, ARE ONLY BINDING IF THEY ARE IN WRITING AND FULLY ACCEPTED BY ALL PARTIES. Client Signature: Date / / Apartments Shown:

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