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APPLY FOR HOUSING

PERSONAL INFORMATION

First Name

Last Name

Address

Phone

Date of Birth

Social Security Number

FORM OF IDENTIFICATION PROVIDED

Select identification type:

Driver's License

Birth Certificate

Social Security Card

State Identification

Upload Proof of Identification

Upload .jpg file only (Max 15MB)

CRIMINAL HISTORY

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

YES

If yes, please state the nature of the crime(s), when and where convicted and disposition of the case(s):

Do you have any current legal pending charges?

YES

If yes, please list charges and upcoming court dates.

Are you currently on probation?

YES

If yes, please list Name or Parole Officer and Contact Information

EMERGENCY CONTACT

Emergency's Contact Information

RENTAL REQUIREMENTS

All applicants must be at least eighteen (18) years of age or older. If you are filling this application out for your family member please make sure to complete all sections completely. All applicants will be responsible for a $225 deposit regardless of circumstances. The monthly rent will be $750.

FAIR HOUSING DISCLOSURE

 The Fair Housing Act of 1968, as amended by the Fair Housing Act Amendments of 1988, prohibits discrimination in housing based on race, color, national origin, religion, sexual orientation, handicap, or familial status. Except as permitted by the Housing for Older Persons Act of 1955, we are committed to complying with the letter and spirit of the laws which administers compliance with the fair housing laws in the United States Department of Housing and Urban Development.  

APPLICANT CERTIFICATION

I certify that the information provided in this Rental Application is true and correct to the best of my knowledge as of the date set forth below. I acknowledge that the Landlord shall rely on the information contained herein and I authorize the Landlord to verify any or all information provided.

Sign Your Name

BUSINESS HOURS

MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY

8:30 A.M. - 4:30 P.M.
8:30 A.M. - 4:30 P.M.
8:30 A.M. - 4:30 P.M.
8:30 A.M. - 4:30 P.M.
8:30 A.M. - 4:30 P.M.
CLOSED
CLOSED

CONTACT INFORMATION

onelifellc19@gmail.com

(615) 647-7018

(615) 647-7019

801 E. OLD HICKORY BLVD. SUITE 130
MADISON, TN 37115

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