Willow Springs On-Line Application

Anything that does not apply, put N/A - all fields must be filled out. Thanks!

First Name *

Middle *

Last Name *

Home Number *

Work Number *

Cell Phone *

Email Address *

Birth date *

Social Security Number *

Marital Status - Please note the each person living in the condo must fill out an individual application. *

Married

Single

Current Landlord Information / Housing history

Where are you currently living? Do you *

Rent

Own a home

Staying with Friends / Relatives

Current Street Address *

Address Line 2

City *

State *

Zip Code *

Name of Property / Landlord *

Phone Number *

Moved In Date *

Lease end date / Moving date *

Monthly Rent Amount *

Balance Due *

Previous Residence / Previous Landlord Information

Where did you live at before? Did you: *

Rent

Own a home

Lived with Friends / Relatives

Previous Street Address *

Address Line 2

City *

State *

Zip Code *

Move In date *

Moved out date *

Monthly rent / payment amount *

Past Due balance amount *

Employer Information

Present Employer *

Supervisors Name *

Phone Number *

Annual Salary *

Address City State Zip

Amount of Months/Years working here *

Previous Employer *

Supervisor's Name

Phone Number

Amount of Months/Years working there *

Income / Debit Information

Gross Monthly Income *

Monthly Payments (Credit Cards, Loans, Car pymts etc) *

Have you ever declared bankruptcy? - This does not disqualify the approval process. *

Yes

Have you ever been convicted of a felony? This does not disqualify the approval process *

Yes

Have you ever been sued for non-payment of a bill? *

Yes

Do you have any outstanding / past due bills? If yes, to whom and how much? *

Any persons living in the condo must fill out a separate application (over the age of 18.) List the names of any persons that will be living with you.

Name persons living with you. *

Relation / Age *

This person is over 18 and has filled out an application. (note - if persons living with you is over 18, then they must fill out an application. Only one application fee is due.) *

Yes

Name of other persons living with you.

Relation / Age

Emergency Contact Name and Phone Number *

What type of property are you interested in?

Willow Springs Condo

Upstairs

Downstairs

Either

2 Bedroom 1 1/2 Bathrooms $825

2 Bedrooms 1 Bathroom $775.

Either

I have my own Washer and Dryer *

Yes

Other Properties - I am applying for an office space or Rutherford Condo

Rutherford Condos at Beringer Commons $1,190/mo

Willow Springs Plaza Office Space

Desired Move In Date: * +

Optional Questions or Requests

Payment Information: Application Fee $25. You can pay the application fee now with a checking account, MasterCard, Visa, Credit or Debit card. If you pay now we can begin the application process. Or you can submit the application now without payment. When you are ready for us to run the application, you can pay the application fee at the office with cash or check. Thank you!

I want to: *

Pay with Master Card

Pay with Visa

Pay with my checking account

Wait to process application / pay latter

Credit Card Information

Name on Card

Credit Card Number

Expiration Date (mm/yy)

Cvv(3 digit #)

Billing Address: City, State, Zip

Pay with Checking Account

Name on Account

Billing Address: City, State, Zip

Routing Number (1st set of numbers on check)

Account Number (2nd set of numbers on check)

I represent that all the above statements are true and complete and hereby authorize verification of such information via credit reports, rental history reports, and other means. *

Yes

I also authorize the $25. application fee to be charged and billed as stated above. *

Yes

No - Wait and process latter.

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