Rental Application — 10406 W 64th St, Shawnee, KS

Rent: $1,695/month · Security deposit: $1,695 · Pet deposit: $500 · Total required: $3,890.
A non-refundable application processing fee of $50 per applicant applies, due before processing begins.
Every adult who will live in the home must submit an application.
Your information is transmitted and stored encrypted, and is used only to process this application, including a credit and background screening run by APTS Inc. (Apartment Personnel & Tenant Solutions, Inc., P.O. Box 9015, Shawnee Mission, KS 66202). Applications are automatically deleted 30 days after submission.

Contact Information

Email Address

Desired Date of Occupancy MM/DD/YYYY

Applicant Information

Applicant — Full Legal Name

Applicant — Social Security Number Format ###-##-####. Used only for the APTS Inc. credit/background screening.

Applicant — Date of Birth MM/DD/YYYY

Applicant — Driver's License State

Applicant — Driver's License Number

Cell Phone

Home Phone

Work Phone

Work Fax

Marital Status

Married Divorced Single

Maiden NameIf applicable

Number of Occupants

Pets?

Yes No

Pet DescriptionIf yes: type, breed, weight

Emergency Contact — Name

Emergency Contact — Phone

Spouse / Co-Applicant

Complete only if a spouse or co-applicant will also occupy the home.

Spouse — Full Legal Name

Spouse — Social Security NumberFormat ###-##-####

Spouse — Date of BirthMM/DD/YYYY

Spouse — Driver's License State

Spouse — Driver's License Number

Residence History A — Last Five Years

Current residence (required)

Residence A — Address (#, City, State, Zip)

Residence A — Home Phone

Residence A — Dates Rented From Month / Year

Residence A — Dates Rented To Month / Year, or 'Present'

Residence A — Landlord/Complex Name & AddressShow mortgage company if buying

Residence A — Landlord Type

Landlord Friend Family

Residence A — Landlord Phone

Residence History B — Last Five Years

Previous residence (if needed to cover five years)

Residence B — Address (#, City, State, Zip)

Residence B — Home Phone

Residence B — Dates Rented FromMonth / Year

Residence B — Dates Rented ToMonth / Year, or 'Present'

Residence B — Landlord/Complex Name & AddressShow mortgage company if buying

Residence B — Landlord Type

Landlord Friend Family

Residence B — Landlord Phone

Residence History C — Last Five Years

Previous residence (if needed to cover five years)

Residence C — Address (#, City, State, Zip)

Residence C — Home Phone

Residence C — Dates Rented FromMonth / Year

Residence C — Dates Rented ToMonth / Year, or 'Present'

Residence C — Landlord/Complex Name & AddressShow mortgage company if buying

Residence C — Landlord Type

Landlord Friend Family

Residence C — Landlord Phone

Employment A

Applicant's current employment (required)

Employment A — Employer

Employment A — Employer Phone

Employment A — Employer Address

Employment A — Position / Department

Employment A — From Month / Year (MM/YYYY)

Employment A — To Month / Year (MM/YYYY), or 'Present'

Employment A — Gross Monthly Income

Employment B

Spouse's employment or 2nd employer (optional)

Employment B — Employer

Employment B — Employer Phone

Employment B — Employer Address

Employment B — Position / Department

Employment B — FromMonth / Year (MM/YYYY)

Employment B — ToMonth / Year (MM/YYYY), or 'Present'

Employment B — Gross Monthly Income

Vehicles, Bank & Other Income

Vehicle 1 — Make, Model & Year

Vehicle 2 — Make, Model & Year

Vehicle 3 — Make, Model & Year

Bank Reference — Bank Name

Bank — Phone

Bank — Address

Bank — How Long

Bank — Account NumberIndicate checking or savings

Other Income & AmountVerification will be requested. List any SSI, pension, disability, student grants, dividends, etc.

Background & Character References

Character references: family excluded.

Full-Time / Part-Time Student?

Yes No

Have you ever been convicted of a felony?

Yes No

Reference 1 — Name

Reference 1 — Address

Reference 1 — Phone

Reference 2 — Name

Reference 2 — Address

Reference 2 — Phone

Co-Signer

Complete only if a co-signer is applying.

Co-Signer — Name

Co-Signer — Social Security NumberFormat ###-##-####

Co-Signer — Date of BirthMM/DD/YYYY

Co-Signer Spouse — Name

Co-Signer Spouse — Social Security NumberFormat ###-##-####

Co-Signer Spouse — Date of BirthMM/DD/YYYY

Co-Signer — Address

Co-Signer — Apt Number

Co-Signer — City, State, Zip

Authorization & Signature

Please read before signing

FALSE STATEMENTS OR INCOMPLETE INFORMATION WILL BE GROUNDS FOR DENIAL OF THIS APPLICATION. This application must be signed by all adults who will occupy the home before it can be considered by Landlord. Acceptance of this application, and any monies deposited herewith, is not binding upon Landlord until approved by Landlord in writing. If approved, monies deposited with this application will be held as a reservation deposit, to be either returned to applicant or credited toward any deposit which may be required by applicant at the time a rental agreement is secured. In compliance with the FAIR CREDIT REPORTING ACT, this notice is to inform you that the processing of this application includes, but is not limited to, making any inquiries deemed necessary to verify the accuracy of the information herein, including procuring consumer reports from consumer credit reporting agencies and obtaining credit information from other credit institutions. The undersigned agrees this application and any information reports will remain the property of Landlord and APTS, Inc. I hereby grant this property and APTS, Inc. the right to process this application for the purpose of obtaining a Rental/Lease Agreement with this property. Additionally, I authorize all corporations, companies, law enforcement agencies, academic institutions, and current and former employers to release information they may have about me, and release them from any liability and responsibility from doing so. A photographic, faxed, or electronic copy of this authorization shall be as valid as the original.

I agree to the authorization above. Typing my full legal name below is my electronic signature. Under federal ESIGN and Kansas law, your typed name with this agreement is a legally valid electronic signature.

Signature — Applicant 1 (type your full legal name)

Signature — Applicant 2 / Spouse (type full legal name)Required if a spouse will occupy the home

Signature — Co-Signer 1 (type full legal name)

Signature — Co-Signer 2 (type full legal name)

Date Signed MM/DD/YYYY