Rental Application Form

We sincerely thank you for your application. Please help us process this application promptly by clearly providing all of the required information. An application fee of $50 must accompany this application before it will be considered. The fee is non-refundable and is not a part of the security deposit. An alternative to submitting an application online is to DOWNLOAD the form, complete it and submit to Christiana Meadows via fax (302-322-9244), as an e-mail attachment, or by mail.

Applicant's Full Name      E-mail Address

Primary Phone Number      Alternate Phone

Social Security Number      Date of Birth (mm/dd/yyyy)      Marital Status ---SingleMarriedSeparatedDivorced

Name 1     S.S.N.     Relationship     D.O.B.

Name 2     S.S.N.     Relationship     D.O.B.

Name 3     S.S.N.     Relationship     D.O.B.

Name 4     S.S.N.     Relationship     D.O.B.

Current Address

Move-In Date (mm/yyyy)     Reason for Leaving

Owner or Agent    Rental Amount $     Landlord's Phone

Previous Address (if within 3 years)

Move-In Date (mm/yyyy)     Reason for Leaving

Owner or Agent    Rental Amount $     Landlord's Phone

Previous Address (if within 3 years)

Move-In Date (mm/yyyy)     Reason for Leaving

Owner or Agent    Rental Amount $     Landlord's Phone

Applicant's Status  Employed Full-Time Employed Part-Time Student Retired Unemployed

Employer   Current Previous

Employer's Address

From Date (mm/yyyy)     To Date (mm/yyyy)     Employed As

Supervisor      Phone     Salary     Period ---Per WeekPer MonthPer Year

If employed by above less than 6 months, please give name & address of previous employer or school:

If there are other sources of income you would like considered, please list income source and person (banker, employer, etc.) whom we could contact for confirmation. You DO NOT have to reveal alimony, child support or spouse's annual income unless you want it considered in this application.

Other Income Amount $     Other Income Source

Other Income Amount $     Other Income Source

Co-Resident's Status  Employed Full-Time Employed Part-Time Student Retired Unemployed

Employer  Current Previous

Employer's Address

From Date (mm/yyyy)     To Date (mm/yyyy)     Employed As

Supervisor      Phone     Salary     Period ---Per WeekPer MonthPer Year

How did you hear about Christiana Meadows?

Please provide any other information about yourself that might help us evaluate your application.

In considering your application, management will rely heavily on the information you have provided. It is important that the information be accurate and complete. By submitting this application, you represent and warrant the accuracy of the information and you authorize management to verify any references you have provided.

Fair Credit Reporting Act Pre-Notification Statement. This is to inform you that as part of the procedure for processing your application, an investigative report may be made whereby information is obtained through personal interviews with third parties, such as family members, business associates, financial sources, friends, neighbors or others with whom you are acquainted. The inquiry includes information as to your character, general reputation, personal characteristics and mode of living, whichever may be applicable. You have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.

If applicant is approved, a lease must be signed within a week from the date of application; otherwise, residence will be re-rented. Exceptions can only be approved by the agent. The security deposit must be paid at the signing of the lease agreement and is equal to a month's rent. This application and the lease form the total agreement. Failure to move in on date specified holds applicant liable to the agreement and loss of monies paid as liquidated damages.