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200809274 RENTAL APPLICATION 2 VtBll3}} 6 8 Propcrty Name: Date: Apartment Size Desired: Number of Bedrooms 1. FAMILY DATA: Name of Head of Household (Head) Spouse Name (if living with the household) Current Address: Street Citv State Zip Dav Phone Night Phone Have you ever used another name? (YIN) If so, please indicate name PLEASE ANSWER ALL QUESTIONS! Do not leave any ,space blank, write "No or NIA" where appropriate. White-out is not acceptable. PLEASE PRINT. Directions to Applicant: Please complete the tablc below for each member of your household, whether or not those members are related. Include all members who you anticipate will live with you at least 50% of the time during the next 12 months. (A full time student is anyone who is enrolled for at least five calendar months during this taxable year for the number of hours or courses which are considered full-time attendance by that institution. The five months need not be consecutive). If you need additional space for answers to any paragraph Iistcd below, attach additional sheets and make sure you include a reference to the paragraph number, your name and your social security number. 2. HOUSEHOLD COMPOSITION: Member Relation Date of Gender Social Student If Yes, PT Number Name(s) To Head Birth (M/F) Securitv # (Y IN) orFT 1. HEAD 2. 3. 4. 5. 6. Do all ofthc above household members rcsidc in the household 100% of the time? (Y/N) - If no, please list the household members that do not live in the household 100% of the time: Anticipated changes in the household size within the next 12 months? (Y/N) _ If Yes, explain Anticipated change in number of students within the next 12 months? (YIN) _ If Yes, explain Current Marital Status: Single_ Married - Divorced - Separated _ Widowed - Are all occupants full time studcnts? Yes _ No _ If Yes, please answer the following: a.) Are any of the students married and entitled to file ajoint Federal Income Tax Return with their spouse? Yes _ No _ (If Yes, attach a copy of the Si!:,'11ed Federal Income Tax Return). b.) Are any of the students receiving assistance under Title IV of the Social Security Act, which includes but is not limited TANF/AFDC? Yes - No - c.) Are any of the students enrolled in ajob training program receiving assistance under the Workforce Investment Act (WIA)/Job Training Partnership (JTPA) Act of under similar Federal, State or local laws? Yes - No - d.) Are any of the students a single parent with minor child(ren) and neither the studcnt, nor -'!!!Y of the minor child(ren) in the household are claimed as a dependent of a third party? Y cs _ No _ (If Yes, and all household members are full time students, a si!:,'11ed copy of your Tax Return and Divorce Decree must be attached).