Rental Application - Harrison Richards, Inc.

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Rental Applicaton

Application Process Step 1: Reserving an Apartment and Acknowledging Fees(Required)

An application fee of $79.00 per applicant is required. Application fees are not refundable. An application must be submitted by anyone residing in the apartment over the age of 18. Applicant agrees to return completed application and supporting documents within 2 days. As a resident, Applicant acknowledges that they will be billed monthly for their pro-rata share of the building's common utilities (water, trash/sewer, gas, electric). Applicant agrees to establish electric, gas (if applicable), and cable/phone/internet in their own name with an outside vendor. Applicant acknowledges parking rent ($59/month/spot) and pet rent ($49/month/pet plus a one-time fee of $295/pet) if applicable. Applicant acknowledges that the quoted rent has been discounted by 10%, and to take advantage of this discount, the rent payment must be received before the 5th of the month.

Acknowledge and Continue

How did you find this apartment?(Required)

Zillow

Trulia

Apartments.com

Drive/Walk By

Other

Please specify.(Required)

Applicant Information

Please note that smoking/vaping is not permitted inside any of our properties.

First Name(Required)

Last Name(Required)

DOB(Required)

SSN(Required)

Cell #

Work #

Drivers License No./State

Total Parking Spaces Needed for Residence

Vehicle 1 Make/Model/Year

Vehicle 2 Make/Model/Year

Vehicle 3 Make/Model/Year

Building and Unit you are Applying for

Expected Start Date of Lease

Are you a U.S. Citizen?(Required)

Yes

Provide Addresses for Prior 24 Months

Present Address

Street, City, State, Zip Code (Present Address)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Own or Rent

Own

Rent

Lease Start Date

Lease End Date

Rent/Mort. Amt

Current Landlord

Landlord Email

Landlord Tel

Former Address

Street, City, State, Zip Code (Former Address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Own or Rent

Own

Rent

Lease Start Date

Lease End Date

Rent/Mort. Amt

Current Landlord

Landlord Email

Landlord Tel

Person(s) to Occupy Apartment in Addition to Applicants

Person's Information

Click "+" to add additional people

Name

Relationship

SSN

DOB

Pets

Tenants must provide current vet records for all pets and license for dogs. There are breed and size restrictions for dogs.

Number and Type(s) of Pets

Age

Weight

Description of Pet(s)

Applicant Employment Information

Your Status(Required)

Full Time

Part-Time

Student

Retired

Not Employed

Self-Employed

Name and Address of Employer(Required)

Current Occupation and Will this be your PA Employer(Required)

Years on Job(Required)

Annual Salary(Required)

Supervisor's Name

Supervisor's Phone #

Name and Address of Past Employer

Previous Occupation

Start Date

End Date

Supervisor's Name

Supervisor's Phone #

Annual Salary

Self-Employment Verification

Name of Business(Required)

What is your business name and type of business/industry?(Required)

What is your business structure (sole proprietorship, LLC, S-corp, etc.)?(Required)

Date Established(Required)

Annual Salary (if none taken, annual income)(Required)

Annual Additional Income

Self-Employed Applicant(s) may be required to provide additional documentation such as tax returns and financial statements.

Bonuses/Commissions (total per year)

Alimony/Child Support (total per year)

Other

In Case of Emergency (Please include at least one local contact)

Name(Required)

Address(Required)

Tel #(Required)

Relationship(Required)

Name(Required)

Address(Required)

Tel #(Required)

Relationship(Required)

I hereby give consent to contact the individuals listed above to discuss an emergency situation.(Required)

I give consent.

Declarations

Are there any outstanding liens or judgements against you?

Yes

Have you been declared bankrupt within the past 7 years?

Yes

Have you had property foreclosed upon or given title or deed in lieu therof in the past 7 years?

Yes

Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan gaurantee? If yes, give details as described in the preceeding question.

Yes

Have you ever broken a rental agreement or lease?

Yes

Have you ever been sued or had your lease terminated due to a non-payment of rent?

Yes

Have you been convicted of a felony or a crime of violence against a person or property?

Yes

Are you listed on any government-sponsored registry naming terrorists, Most Wanted criminals or sex offenders?

Yes

Will any smokers be occupying the apartment?

Yes

Non-U.S. Citizen Supplement

Each co-resident and each occupant over 18 who is not a U.S. citizen must submit a separate application. We are requesting you to fill out this Supplemental Rental Application Section because you have indicated that you are not a U.S. citizen. We are asking all applicants who are not U.S. citizens to fill out this section. We are committed to compliance with fair housing laws and do not discriminate based on race, color, religion, sex, national origin, handicap or familial status. The purpose of this section is to determine whether your right to be in the U.S. expires during your Lease Contract term.

Form I-551 Permanent Resident Card or Alien Registration Receipt Card (Includes photo and fingerprint)

Card number:

Form I-766 or I-766A Employment Authorization Document Card (Includes photo and fingerprint)

Card number:

Expiration Date

Form I-94 or Form I-94A with Arrival-Departure Record (form does not include photo or fingerprint)

Card number:

Expiration Date

Do you have the INS receipt for the replacement of one of the above documents, with verification by INS of your entitlement to the above? If yes, please describe.

Do you have any other official USCIS documents? If yes, please describe.

Non-U.S. Citizen Supplement for Reliance on Form I-94

If you are a non-U.S. citizen relying on Form I-94, we must see your passport and visa, and you will need to answer the questions below.

Country Issuing your Passport

Passport Number

Passport Expiration Date

Do you have a visa, and if yes, what type?

Visa Expiration Date

Non U.S. Citizen Agreement

Please read and respond to the clause below.(Required)

The Applicant represents that all the statements herein are true, and if they change during the term of the tenancy, he/she will immediately notify the management staff.

Please provide the date of signing:(Required)

Document Uploads

Please submit your three most recent bank statements, three most recent pay stubs, and legal identification (state issued driver's license, passport, or visa).

Files(Required)

Drop files here or

Max. file size: 100 MB.

Acknowledgement and Agreement

Note: It is your responsibility to furnish the following upon request: identification, proof of income, landlord references for the past 2 years, satisfactory credit rating or higher, and proof of renter’s insurance. Non-US citizens will need to provide copies of their passport and visa. Harrison Richards, Inc. and the owner are committed to comply with all federal, state and local fair housing and equal housing opportunity laws.

Please read and approve the agreement.(Required)

I understand that if I do not elect to move forward with signing the lease, the security deposit will not be returned. It is understood that the application fee is not refundable. If the reservation fee is paid with a credit/debit card, a 3.75% fee will be deducted if returned for any reason. I understand that all Harrison Richards, Inc. properties are non-smoking properties and smoking/vaping is prohibited anywhere on the premises. I hereby authorize Harrison Richards, Inc. to verify all information in this application, including specifically to obtain public and non-public references and credit reports or records and criminal (including sex offender) background records, if applicable. I authorize Harrison Richards, Inc. (including a third-party collection agency) to obtain such references and reports at any time during the term of my tenancy and after termination of my lease, if such reports are needed in attempting to review my continuing eligibility to be a resident, collect any defaulted payments or charges, or for any other permissible purpose. Applicant represents that all the statements herein are true.

Please provide the date of signing.(Required)

Important: please do not reload this page until you have completed and submitted your application. If you reload midway through filling out the application, your changes will not save.