PERSONAL INFORMATION & UNIT ADDRESS Full Name: Email address: Phone Number: Rental Unit Address: Amount Submitted:
fails to pay the balance of all move-funds, if any, (security deposit, pet fees, etc.) by the date above, the Lessor (landlord) will no longer be obligated to reserve this unit for the Applicant and will have no obligation to rent ANY unit to the Applicant, and the Applicant will forfeit all of the holding deposit.(not to exceed the equivalent of one month's rent ) In addition, if the Applicant is approved by the landlord, but changes his/her mind about renting, the Applicant will forfeit all of the holding deposit.
IMPORTANT : Any false or misleading information provided by the Applicant will result in forfeiture of the ENTIRE HOLDING DEPOSIT without question or exception, EVEN IF it is discovered AFTER the applicant is accepted.
Applicant shall be entitled to a full refund of the holding deposit within 5 days if:
The landlord does not approve the Applicant 's rental application, or
The unit becomes unavailable.
Please Select Your Answer
Yes, I Understand and Agree
No, I need more information, or am filling this form out for a different purpose
Typing your full name in the box below consitutes your legally binding signature:
ACH Form (aka: Debit Authorization)
PERSONAL INFORMATION & UNIT ADDRESS
*You can skip filling out the PERSONAL INFORMATION & UNIT ADDRESS a second time if you've already filled those fields out in the holding deposit section above.
Full Name: Email address: Phone Number: Rental Unit Address: BANKING INFORMATION Bank Name
Bank Address, City and Zip
Bank Routing Number:
Bank Account Number: Type of Account:
Please Select Account Type Checking Savings*
Note: If you use your savings account instead of a checking account, keep in mind that Federal law prohibits more than 6 electronic transactions per month from a savings account. Also, be certain to choose the correct account type. If you choose "savings" and your account is actually a "checking", the payment will fail, and you will be charged a $7 fee for failed transaction.
Use the fields below to authorize the payment of your holding deposit (if not already paid in cash), security deposit, ongoing rent & other one-time or ongoing payments where indicated. You can specify a date, but that date must be at least 7 (seven) business days prior to lease signing. If lease signing is within 7 business days, you should pay cash or certified funds before or at lease signing. If you leave the "date" field blank, we will simply withdraw the funds per our judgment or your separate instructions, if any. If you have any doubts or questions, contact us.
Holding Deposit Amount:
Holding Deposit Date:
Rental Unit Address:
Ongoing Monthly Rent Amount:
Security Deposit Amount:
Security Deposit Date:
Other One-time Payment Amount:
Other One-time Payment Date:
Other One-time Payment Description:
Other Notes or Instructions:
Please Select Your Answer
Yes, I Understand and Agree
No
Typing your full name in the box consitutes your legally binding signature:
