SCM PROPERTY MANAGEMENT

504 N. GEORGE ST.

ROME, NEW YORK 13440
(315) 281-0081 (315) 337-6145 - fax
smalorzo@hotmail.com - e-mail

TYPE/SIZE OF APARTMENT WANTED: ___________________________________

DATE WANTED _________________________________________________________

APPLICANT'S FULL NAME: ______________________________________________

DATE OF BIRTH: ________________________________________________________
SOCIAL SECURITY NO.__________________________________________________

PRESENT ADDRESS: ____________________________________________________

PRESENT TELEPHONE: __________________________________________________
PRESENT LANDLORD'S PHONE: __________________________________________

HOW LONG HAVE YOU LIVED AT PRESENT ADDRESS_____________________

AMOUNT OF RENT: _____________________________________________________
REASON FOR MOVING:__________________________________________________

PREVIOUS ADDRESS:____________________________________________________
PREVIOUS LANDLORD AND PHONE NUMBER:_____________________________

HOW LONG DID YOU LIVE AT PREVIOUS ADDRESS: _______________________

EMPLOYED BY: _________________________________ HOW LONG?___________

EMPLOYER'S ADDRESS__________________________ TELEPHONE: __________

YOUR POSITION________________________________________________________

OTHER RESIDENTS RESIDING IN HOME: WE NEED ADULTS SOCIAL

SECURITY NUMBERS AND DATE OF BIRTH:
_______________________________________________________________________
_
_______________________________________________________________________
_
_______________________________________________________________________
_
_______________________________________________________________________
_

EMPLOYMENT OF CO-RESIDENT: ________________________________________

DO YOU HAVE ANY PETS? _______________HOW MANY? ___________________
DO YOU OWN FURNITURE: ______________
HOUSEHOLD INCOME: __________________
AUTOMOBILE: _________________________YEAR_______COLOR_____________
TAG #_________________STATE: ____________
IN CASE OF EMERGENCY, NOTIFY: ______________________________________
_______________________________________________________________________
ADDRESS_____________________________________TELEPHONE______________

I hereby make application for an apartment or home and certify that the above
information is correct. I authorize you to contact any references that I have listed. I
understand that I will receive my security deposit back if application is denied. I
understand that I will automatically forfeit security deposit if application has been
accepted and I decide not to accept apartment for any reason. There is a credit check.

Applicants Signature: ______________________________________________________

Co-Signed: ______________________________________________________________
Date: ___________________________________________________________________