Frontier Management of NY, Inc. Rental Application Form

Application To Lease

(All required questions must be answered)

PROPERTY APPLYING FOR

Are you currently a student?

If yes, where?

We are an equal housing opportunity provider. We do not discriminate on the Basis of race, color, religion, sex, family status, national origin or handicap.

Applying For: *

1 Bedroom
2 Bedroom

Name *

Address *

Address Line 1

City

State

Zip Code

Phone *

Email *

Date of Birth *

Drivers License Number *

DO YOU RENT OR OWN *

Own
Rent
Other

If Other, please provide explaination:

Rent or Monthly Payment Cost *

Landlord *

How Long Did You Stay at This Address? *

Landlord Phone Number *

Reason For Leaving *

EMPLOYMENT

Are You Currently Employed? *

Employer *

Employer Phone Number

Employer Address *

Address Line 1

Address Line 2

City

State

Zip Code

Occupation *

How long *

Salary *

HOW OFTEN ARE YOU PAID? *

Weekly
Bi-Weekly
Annual

Other Income *

Source

ADDITONAL OCCUPANTS

Will There Be Additional Occupants Beside Yourself? *

PERSONAL REFERENCES

Reference 1 Name

Reference 1 Relationship

Reference 1 Phone

Reference 2 Name

Reference 2 Relationship

Reference 2 Phone

Have you ever refused to pay rent? *

If yes please Explain

Have you filed bankruptcy in the last ten years? *

If yes please Explain

Have you been convicted of committing a crime? *

Please note that criminal conviction will not necessarily ban you from housing.

If yes please Explain

I have the following situations which might influence my credit stand

(check all that my apply)

My signature below serves as permission for Frontier Management of NY, Inc. to verify the accuracy of all statements in this application, and to obtain present and previous landlord references, income and employment verification and credit history and criminal background check for applicant, co-applicant and guarantor. Applicant attests that all information on this application is correct and complete. The undersigned makes the foregoing representation knowing that if any such information proves false, the management may cancel any lease given in reliance upon such information at any time.

DEPOSIT AGREEMENT

The acceptance of this Application and/or a deposit does not constitute an approval of the application, or an agreement to
lease, or a lease on the part of the Landlord. If the Landlord does not approve this application, the sum deposited shall be
returned to the applicant, less any application fee paid.
Applicant has the right to cancel this application within forty-eight (48) hours of the signing of this application. If Applicant
cancels this application within the forty-eight hour period, a handling fee of $20.00 will be charged to the Applicant for the
paperwork, rental and office expense involved in the processing of the application. If Applicant cancels this application after
the forty-eight hour grace period, and prior to the signing of a lease agreement, Applicant agrees that the full deposit received
along with this application will be retained for liquidated damages and payment of the cancellation. In consideration for
payment of this sum, the Landlord agrees to completely release the Applicant from this application agreement.
In the event the Applicant has indicated to the Landlord on this application that the Applicant will provide a guarantor
residing in New York State and the Landlord requests the Applicant to provide such guarantor, the Applicant will supply a
guarantor within three (3) days of the receipt of such request. The Applicant expressly acknowledges that in the event that the
Applicant does not supply a guarantor upon request, the deposit received as part of this application will be retained for
liquidated damages and the release from this application.
If the Applicant does not return the signed lease within seventy-two (72) hours from written request by the Landlord, this
application, at the Landlord's option, may be considered null and void. In such event, the Landlord will retain the deposit as
part of liquidated damages.
If the Landlord accepts this application to lease, this application shall be deemed a part of the lease.

There is a $20.00 application fee to process this application. All Application fees are non-refundable. Please enclose
payment in the form of money order payable to the property name.

My signature below serves as permission for Frontier Management of NY, Inc. to verify the accuracy of all statements in this
application, and to obtain present and previous landlord references, income and employment verification and credit history for
applicant, co-applicant and guarantor. Applicant attests that all information on this application is correct and complete. The
undersigned makes the foregoing representation knowing that if any such information proves false, the management may cancel
any lease given in reliance upon such information at any time.

Date

Internal Use Only

Application Fee Paid:

Check #:

Date: