APPLICATION AND AGREEMENT
Squaw Creek Village, Ltd.
APPLICANT INFORMATION: Please include $25.00 Application
Fee & Copy of Drivers License
Today’s Date _____-____-______
(1) Name
___________________________________________________________________________
First
M.I. Last
Maiden Name
D.O.B. _________-________-_________
S.S. # _________-_________-_________
Present Address ____________________________________________________________________
____________________________________________________________
How Long? ____________
City
County
State Zip Code
Telephone Numbers: Home (
) ________-___________ Cell phone (
) _______-___________
Have you lived in other
States? _________ Where & When?
_____________________________________________
E-mail Address
___________________________________________________________________________________
SPOUSE OR CO-APPLICANT INFORMATION
(2) Name
____________________________________________ ______________________________
First
M.I. Last
Maiden Name
D.O.B.
_________-________-________
S.S. #
_________-_________-_________
Present Address
____________________________________________________________________
____________________________________________________________
How Long? ____________
City
County
State Zip Code
Telephone Number Home
( ) ________-___________ Cell phone
( ) _______-___________
Have you lived in other
States? _________ Where & When?
_____________________________________________
E-mail Address
___________________________________________________________________________________
OTHERS TO RESIDE WITH YOU: Anyone 18 yrs. old or older must complete an Application
Name ________________________________________
DOB______________ Age ________
Grade ________
Name
________________________________________ DOB______________ Age ________ Grade ________
Name
________________________________________ DOB______________ Age ________ Grade ________
Name
________________________________________ DOB______________ Age ________ Grade ________
Pets: Limit of 3 Animals – Dogs $10.00 & Cats $5.00 each per
month
Animal
____________________ Breed ________________________ Gender _____ Weight
_________ Age ________
Animal
____________________ Breed ________________________ Gender _____ Weight
_________ Age ________
Animal
____________________ Breed ________________________ Gender _____ Weight
_________ Age ________
EMPLOYMENT
HISTORY
(1) Present Employer
Name
__________________________________ Address
_________________________________
Job Title
________________________________
How Long
Employed? _____________________ Monthly
Salary $ __________________________
Supervisor
______________________________ Phone
( ) __________-__________________
Previous Employer
Name
__________________________________ Address
_________________________________
Job
Title ________________________________ City
_________________St ____ Zip __________
How Long
Employed? _____________________ Monthly
Salary $ __________________________
Supervisor
______________________________ Phone
( ) __________-___________________
(2) Spouse or
Co-Applicant’s Employer
Name
__________________________________ Address _________________________________
Job Title
________________________________ City
________________ St ____ Zip___________
How Long
Employed? _____________________ Monthly
Salary $ __________________________
Supervisor
______________________________ Phone
( ) __________-___________________
RESIDENTIAL HISTORY
Date
occupancy is desired? ______ Do you currently rent? ______ Do you currently own
residence? _______
Present Lien holder (if you own residence): How long? _______ _
__ Monthly Payment? _________
Name: ______________________________ Address:
_______________________________________
Phone:
FAX # ________________________ Reason for leaving?
_____________________________________
Current Landlord (if you rent): How long? ________________ Monthly Payment? ______________
Name
______________________________ Address:
________________________________________
Phone:
_____________________________ City_____________________ ST_____ Zip____________
FAX
# ________________________ Reason for leaving? _____________________________________
Previous Landlord(s): How long? ______________ Monthly Payment? ________________________
Name
______________________________ Address:
________________________________________
Phone:
FAX
# _________________________ Reason for leaving?
____________________________________
HOME AND AUTOMOBILE
Manufactured Home: Are you looking to Own? ____________ Rent? _____________
Address of home interested in:
_________________________________________________________
Name of Lender
______________________________________________ Bal. owed $_____________
Make/Model __________________________ Year
__________Length ___________Width _________
Present Location
____________________________________________________________________
Name of Seller
____________________________Seller’s Address ____________________________
Automobile(s):
Parking
available for two automobiles, do you have more than two? _________________
Make
________________________________________ Model
________________________________________
Year
________________ Color
_____________________ License Plate # _________________________
Make
________________________________________ Model
________________________________________
Year
________________ Color
_____________________ License Plate #
_________________________
Other Licensed Vehicles:
(campers, boats, mopeds, motorcycles, trucks, RV’s, etc.)
Make
________________________________________ Model
________________________________________
Year
________________ Color
_____________________ License Plate # _________________________
Make
________________________________________ Model
________________________________________
Year
________________ Color
_____________________ License Plate # _________________________
CREDIT REFERENCES
Personal References:
Name
___________________________________________ Phone
( ) __________-_________________
Address
_________________________________________ Relationship
_____________________________
_________________________________________
Name
___________________________________________ Phone
( ) __________-_________________
Address
_________________________________________ Relationship
_____________________________
_________________________________________
Name
of someone you know residing in the Community:
________________________________________________________
How
did you here about
Bank(s):
Name
_______________________________________________ Checking Account #
______________________
Address
_____________________________________________ Savings Account #
_______________________
______________________________________________
Installment Loan _________________________
Name
_______________________________________________ Checking Account #
______________________
Address
_____________________________________________ Savings Account # ____________________
______________________________________________
Installment Loan ____________________
Credit Card(s):
Name
________________________________________ Name
_______________________________________
Address
______________________________________
Address______________________________________
CRIMINAL
HISTORY
Have you ever been arrested
on a charge involving the use of illegal drugs, substance abuse or any
related charge? (1)_______ (2)_______ If yes, please indicate the date of
arrest, the name of the arresting authority, the law violations with which you
were charged, and any other details of which you are
aware._________________________________________________________
____________________________________________________________________________
Have you ever been convicted
on a charge involving the use of illegal drugs, substance abuse or any related
charge? (1)_______ (2)______If yes, please indicate the date of conviction, the
court in which you were convicted, the law violations of which you were
convicted and any other details of which you are aware.___________________________________________________
____________________________________________________________________________
Have you ever been convicted of a felony or aggravated
misdemeanor? (1)______ (2)______ If yes, please indicate the date of conviction,
the court in which you were convicted, the violations of which you were
convicted, and any other details of which you are aware. _______
____________________________________________________________________________
Have you ever been a defendant in a Forcible Entry and Detainer
(eviction) action? (1) _____
(2)______ If yes, give details of time and circumstances.
_______________________________
____________________________________________________________________________
Have you ever been sued for
rent? (1)_____ (2)_____ If yes, please explain the circumstances and
outcome. _________________________________________________________________
____________________________________________________________________________
COMMENTS/EXPLANATION
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I have read the rules
and regulations of the Community and if I am a resident, I agree to abide by
them. Furthermore, I represent that the above information contained in this
Application and Agreement is true and complete. I authorize the owner of the
community, or its agents, to verify the information provided above, obtain
additional information concerning my credit standing, and to furnish the same
to others. If it ever becomes necessary for service of process upon me, in
addition to all other lawful forms and methods of service, I hereby authorize
service of process upon any person identified in my Registration Form to be
contacted in case of emergency, and I agree that such service shall be deemed
good and sufficient for all purposes as if I had been served personally.
Finally, I agree that if there is a change in any of the information contained
in this application, I will notify the Landlord or Manager within ten (10) days
of said change. The undertakings in this Agreement will continue even after the
execution of a Rental Agreement.
Signed ________________________________________________ _________________
Applicant
Date
Signed ________________________________________________ __________________ Applicant
Date