Address of Apartment Applying For:

Move-in date desired:

Name: (First)                                 (Middle)                      (Last)

Any credit under other names?

Date of Birth:

D.L.#/State/Expiration:

Soc. Sec. #:

Home Phone:                        Work Phone:

Cellular Phone:

Proposed Occupants: List all others excluding yourself

Name: (First)                              (Middle)                      (Last)

Age:

Name: (First)                              (Middle)                      (Last)

Age:

Current Address:

Apt. #

Rent $:

(City)                                             (State)               (Zip)

Move in Date:                         Move out Date:

Property Owner/Manager Name:

Manager's Phone

Reason for Moving:

Previous Address:

Apt. #:

Rent $:

(City)                                             (State)               (Zip)

Move in Date:                         Move out Date:

Property Owner/Manager Name:

Manager's Phone:

Reason for Moving:

Previous Address:

Apt. #:

Rent $:

(City)                                             (State)               (Zip)

Move in Date:                         Move out Date:

Property Owner/Manager Name:

Manager's Phone:

Reason for Moving:

Have you ever been or are you now being evicted from a residence? YES NO

If yes, please explain:

Pets?               How many?           Type?

Do you own a waterbed?

Personal Vehicle Info:

(Make)                                             (Model)                                                  (Year)                               (Plate #)

Incorporated/Company Vehicle Info:

(Make)                                             (Model)                                                  (Year)                               (Plate #)

Current Employer:

Title:                           How long?                  Mo. Income $

Address:

Supervisor: Phone:

Previous Employer:

Title:                           How long?                  Mo. Income $

Address:

Supervisor: Phone:

If other sources of additional income are to be used to meet income requirements, please specify
type (___________________) of additional income and attach income statements to your application.

Have you ever filed bankruptcy?

When?

Judgments/Collections Against You?

Auto Loan?

Monthly payment?

Total Monthly Debt/Credit Payments?

Bank:

Branch Address:

Type of Accounts Held?

In case of Emergency, Notify:                                    Relationship:

Address:                                                                  Phone:

(Street)                                                                                   (City)                                              (State)                   (Zip)

Character References:

1._______________________________________________ Relationship____________ Phone (____)_____________

2._______________________________________________ Relationship____________ Phone (____)_____________

The undersigned declares that the information on this Rental Application is true and correct, and understands that false statements may result in rejection of this and any future applications for housing which HPM manages. The undersigned does further understand that all persons of firms named may freely give any requested information concerning the undersigned and hereby waives all right to action for any consequences resulting from such information. My signature below authorizes investigation of all statements contained herein by the management company, including but not limited to a credit check. I further understand and agree that HPM will rely upon this Rental Application as an inducement for entering into a rental agreement or lease and I warrant that the facts contained in this Application are true. If any facts are proven to be untrue, HPM may terminate my tenancy immediately and collect any damages incurred, including reasonable attorneys fees resulting therefrom. All or part of the above information may be made available to other screening and collection services. Pursuant to California Law, you are also herein notified that a negative credit report reflecting on your credit record may be submitted in the future to a credit reporting agency if you fail to fulfill the terms of your rental obligations or if you default in those obligations in any way. HPM welcomes all applicants. It is illegal and against our policy to discriminate against any person because of race, color, religion, sex, sexual orientation, national origin, mental or physical disability, or familial status.