Online Application

Desired Date of Occupancy*

Residence Requested*
Select a Property1604 East University505 S. Swain Avenue303 South Washington Street - Apartment #1 (North)303 South Washington Street - Apartment #2 (South)1824 East Hunter905 South Henderson1101 South Henderson916 East Maxwell

Names of Co-Applicants

Name*

First

Last

Date of Birth*

Email*

Phone*

Primary Bank

How Many Pets Do You or Other Occupants Own?

Kind of Pet, Breed, Weight, and Age

How Did You Hear About Our Property?*

Present Address

Street Address

Address Line 2

City

—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
State

Zip Code

Dates of Residence

Phone Number at Residence

Landlord or Mortgage Company

Phone Number for Landlord or Mortgage Company

Monthly Payment

Reason for Moving

Present Employer

Dates of Employment

Employer Address

Street Address

Address Line 2

City

—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
State

Zip Code

Employer Phone Number

Position

Supervisor

Gross Monthly Salary

If you are an IU Student please list school and degree sought

Total Number of Vehicles (Including Company Vehicles)

Make/Model of Vehicle 1

Year of Vehicle 1

Make/Model of Vehicle 2

Year of Vehicle 2

Other Car, Motorcycle, etc.

Been Sued for Non-payment of Rent?
YesNo

Been Evicted or Asked to Move Out?
YesNo

Broken a Rental Agreement or Lease?
YesNo

Been Sued for Damage to Rental Property?
YesNo

Declared Bankruptcy?
YesNo

Emergency Contact Name

First

Last

Relationship with Emergency Contact

Emergency Contact Address

Street Address

Address Line 2

City

—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
State

Zip Code

Emergency Contact Home Phone

Emergency Contact Work Phone

I hereby make application for a home and certify that this information is correct. I authorize you to contact any references that I have listed. I also authorize you to obtain my consumer credit report from your credit reporting agency, which will appear as an inquiry on my file.

Please print as a PDF to Crimson Rentals Inc. or press Submit to email.