Residence Applying For: *
- Select Address 817 Nassau Street 1206 Carlton Ave., Charlottesville, VA 22902 1011 Montrose Avenue - SUBLET 979 Devon Spring Court 1004 Ridge Street 2598 Ravenscroft Way

First Name: *

Middle

Last Name *

Social Security Number *

Date of Birth *
Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year

E-mail Address *

Cell Phone:

Work Phone:

Home Phone:

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Current Street Address *

City *

State *

Zip *

Current Rent Amount *

Years at this Address? *

Current Landlord Name *

Current Landlord E-mail *

Current Landlord Phone *

Previous Address *

City *

State *

Zip *

Years at this Address? *

Previous Landlord Name *

Previous Landlord E-mail *

Previous Landlord Phone *

Present Employer

How Long?

Position

Salary (Wk, Mo, Yr?) *

Supervisor Name/Contact

Other Income

Other Expenses (Auto, Util., Food, Etc.)

Vehicle(s)

Make/Model

License Plate #

Name *

Street Address *

City *

State *

Zip *

Relationship *

Phone *

E-mail *

Reason for leaving current residence *

Website

HOTPADS

Apts.com

ZUMPER

Sign

Other

Check if any applicant owns any of the following:

Camper

Motorcycle

Boat

Trailer

REQUESTS: List items requested to be done prior to move-in, if any. (If the Owner agrees to any work requested it will be incorporated into the special provisions of the lease. Owner may turn down an application based upon requests)

DISCLOSURE OF BROKERAGE RELATIONSHIP FOR UNREPRESENTED PARTY(IES):THE UNDERSIGNED UNREPRESENTED PARTY(IES) DO HEREBY ACKNOWLEDGE DISCLOSURE THAT THE LICENSEES: WHITNEY GODFREY (BROKER) & JOSH MCELHENY (LICENSEE) ASSOCIATED WITH GODFREY PROPERTY MANAGEMENT, INC. (BROKERAGE FIRM) REPRESENTS ONLY THE LANDLORD/PROPERTY OWNER IN A REAL ESTATE TRANSACTION.

*$38/person over 18 years old.  $32/person for Section 8 Housing applicants.

1. A Non-refundable fee of __*________is hereby accepted to cover the expense of verifying the application information through Datamax Credit Bureau, Equifax and other sources named herein. You hereby acknowledge and agree that inquiry can be made for the purpose of verification of information and the obtaining of character and financial information that may be necessary for processing this application and for verifying your address(es) including but not limited to criminal background information. Applicant should exercise whatever due diligence Applicant deems necessary with respect to info. On the Dwelling Unit, including without limitation, mold, lead-based paint, pests or insects, & any sexual offenders registered under Chpt. 23 (sec. 19.2-387 et seq.) of Title 19. Info. Regarding registered sex offenders may be obtained by contacting the local police dept. or State Police, Central Records Exchange at 804-674- 2000 or www.vsp.state.va.us.

2. All special requirements must be in writing on page one, Section C of rental agreement. These requirements should be submitted with application to be approved prior to a lease being drawn up. WE MAKE NO VERBAL COMMITMENTS/GUARANTEES ANYTIME DURING THE PREVIEW OR LEASE PROCESS/TERM. ALL CONTRACT TERMS WILL BE IN WRITING ONLY. LEASING ASSOCIATE HAS NO AUTHORITY TO MAKE ANY PROMISES OR ANSWER QUESTIONS ABOUT THE HOUSE OR LEASE VERBALLY. ALL QUESTIONS/REQUESTS MUST BE PRESENTED IN WRITING AND A WRITTEN RESPONSE WILL BE PROVIDED FOR RECORD KEEPING PURPOSES. EMAIL YOUR QUESTIONS. DO NOT MAKE ANY ASSUMPTIONS BASED ON ANY VERBAL CONVERSATIONS WITH THE PERSON WHO LETS YOU INSIDE TO WALK THROUGH THE PROPERTY. OBTAIN WRITTEN CONFIRMATION ON ANY VERBAL QUESTIONS YOU ASK .

3. I/We hereby certify that I/We are above legal age, and that all information on this application is true and correct to the best of my/our knowledge. Any rental agreement made on the strength of material information may be terminated at any time at owner/management?s option if it is found to be false.

4. This application if approved becomes part of the rental agreement.

5. In addition, I/we understand that the rules and regulations of the community are also a part of the rental agreement, and agree to abide by them if accepted as a resident.

6. Godfrey Property Management, Inc., hereby discloses that we work for the owner(s) of the property.

7. Applicant hereby authorizes Godfrey Property Management Inc. to obtain rental and payment history information from current and previous landlords & any other sources in order to make a rent offer decision.