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FIA PROPERTIES LLC 1168 James Avenue, Saint Paul, MN 55105 PHONE: 612-223-4559 PLEASE FILL OUT COMPLETELY Property Address: Last Name First FULL Name Marital Status Date of Birth Home Phone Work Phone Cell Phone Do You Text Yes No Must have last 5 years of residence. If more space is needed, please use the back of the page Present Address City Rent State ZIP Present Landlord/Apartment Complex Name Rent State Former Landlord/Apartment Complex Name Employer Own State Monthly Rent How long at Present Address? Pres. Landlord City/State/Zip From To Own ZIP How long at Former Address? FL Phone From To Monthly Rent Apt. # Former Landlord Complete Address Employer Address Position/Title PL Phone Monthly Rent Apt. # Former Landlord Complete Address Rent Former Landlord/Apartment Complex Name To Apt. # ZIP Former Address (2) City From Present Landlord Address Former Address (1) City Own How long at Former Address? FL Phone Employer Phone Gross Monthly Salary From To Immediate Supervisor Name and Title Supervisor’s Phone Number of Vehicles State of Issue Driver License Number Vehicle(s) Make and Model License Plate Number (1) License Plate Number (2) Additional Income (describe source) Personal Reference (Name) Complete Address Phone Number Relationship to Applicant In Emergency Notify (Name of nearest relative) Complete Address Phone Number Relationship to Applicant HAVE YOU EVER BEEN CHARGED WITH OR CONVICTED OF A FELONY? Yes No HAVE YOU EVER BEEN CONVICTED OF A SEXUAL OFFENSE? Yes No HAVE YOU EVER BEEN CONVICTED FOR POSESSION, USE OR SALE OF ILLEGAL SUBSTANCES? Yes No HAVE YOU EVER BEEN EVICTED OR HAD YOUR LEASE TERMINATED IN LIEU OF AN EVICTION? Yes No Do you have any pets_______________ Type(s)________________Breed(s)_________________________ Weight(s)__________ LIST ALL OTHER OCCUPANTS WHO WILL RESIDE IN HOME? (All occupants over 17 must file separate applications) 1 Name:_______________________________ Age:________ 2 Name:_______________________________ Age:_________ 3 Name:________________________________ Age:________ 4 Name:_______________________________ Age:________ Your Email Address ALL RENTS ARE DUE AND PAYABLE ON THE FIRST DAY OF EACH MONTH IN ADVANCE. Pursuant to Fair Housing Laws, the management shall neither refuse to rent or lease an apartment to any person because of race, color, creed religion, national origin, ancestry, handicaps, or familial status of the applicant nor discriminate in the terms offered or the services rendered. The undersigned warrants and represents that all statements herein are true and permits verification. Should it be determined prior to or at any time during the subsequent tenancy that information given was false, Landlord reserves the right to terminate said tenancy immediately. The undersigned agrees to provide documentation necessary to substantiate present or prior earnings which are to be considered as a basis for payment of rent. The undersigned further agrees to execute upon presentation a lease in usual form on the terms and conditions stated. The lease may be terminated by the Lessor if any statement herein made is not true. The application and deposit are taken subject to previous applications. The management is not responsible for loss by fire, smoke, or water. I hereby give permission to obtain information on my credit, rental history, criminal history, income verification, and other references as stated above for the purpose of this application. __________________________________________________________ Prospective Resident Signature Date ___________________________ Desired Move in Date _______________________________________ Printed Name PLEASE INCLUDE A COPY OF YOUR DRIVERS LICENSE (This property will stay on the market until all completed applications and deposit(s) are submitted to Fia Properties LLC)