Online Rental Application

1. *** NOTE: BEFORE SUBMITTING AN APPLICATION PLEASE CALL BRITTANY AT 712-722-3286 TO SEE IF THERE IS AN AVAILABLE APARTMENT ***Please fill out the following Residential Lease Application. Once ssubmitted please complete the payment portion to pay the $35 application fee. After we have received the application and fee we will contact you to set up a time to meet and have an interview.

   • Primary Applicant's Information

   • Applicant Name*
     First Last
   • Applicant Date of Birth*
     MM slash DD slash YYYY
   • Applicant Email*
   • Applicant Phone Number*
   • Names and Ages of Dependents who will reside in the residence
   • Do you have a pet?*
     • No
     • Yes
   • If yes, please describe your pet (breed, weight, etc.)
   • Is there a second tenant age 18+ that will reside with you? IF YES THEY MUST ALSO FILL OUT AND SUBMIT THIS FORM.*
     • No
     • Yes

   • Primary Applicant's Residential History

   • Current Address*
     Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
   • Month/Year Moved In*
   • Owner/Agent*
     First Last
   • Owner/Agent Phone*
   • Monthly Rent ($)*
   • Reason for Leaving*
   • Previous Address*
     Street Address City State ZIP / Postal Code
   • Month/Year Moved In*
   • Owner/Agent Name*
     First Last
   • Owner/Agent Phone*
   • Monthly Rent ($)*
   • Reason for Leaving*

   • Primary Applicant's Credit History

   • Have you declared bankruptcy in the past 7 years?*
     • Yes
     • No
   • Have you ever been evicted from a rental residence?*
     • Yes
     • No
   • Have you had 2 or more late rental payments in the last year?*
     • Yes
     • No
   • Have you ever willfully or intentionally refused to pay rent when due?*
     • Yes
     • No

   • Primary Applicant's Employment Information

   • • Full-Time
     • Part-Time
   • Place of Employment*
   • Dates Employed*
   • Job Title*
   • Supervisor Name*
   • Supervisor Phone Number*
   • Current Salary ($)*

   • References

   • Name*
     First Last
   • Phone*
   • Relationship*
   • Application Fee
   • Credit Card*