PARKOFF ORGANIZATION 98 Cutermill Road, Suite 448 RENTAL Great Neck, New York 11021 APPLICATION 90 (718) 225-5046 af mat ups separate Renal Appicatoa Form [NUTAPRLICATIONS MUST RE SUBMITTED Wifi" 3100 MONEY ORDER OR CASH, WHCH IS NON-REINDABLE. The andzigned hereby makes appt o ete amber Toca at — Tt HCE ‘PLEASE THT UW ABOUT YOURSELF FULL NAME = tone Dae oie Social Seay No ame of Co-Appicant Social Secuiy No, Ages of Dependents _ amber of Dependant (eeluing Co-Appican) (ther Ossapats i Their Relationship, Pes (Number and Kind). PLEASE GIVE YOUR RESIDENY CURRENT ADDRESS Month & Yea Moved Ia Owner Agent — PREVIOUS ADDRESS (i within 3 yeas) ‘Month & Veur Moved in_ Owner Agent _ PREVIOUS ADDRESS (I within 3 yeas) _ Month & Year Moved In Reason farang — Prone) PLEASE GIVE YOUR EI Owner of Agent YOURSTATUS. Cltapioed FaTine Chenpinedacctine — C]suiior (Raves [Jusemanas fcument Cl Previows EMPLOYER, Duss) Employed _Emphyed a, Supervisor : = Supervisors Phore( Adress = : Salary ‘Werployed by above les than 6 montis, giv name and adres of Previous Employer f Schoo _ - ‘rea tr ors of acne ou wold ie scons lee ince sea pee (Baer Ep, et) wn we old ont rit "Yor do NOT favo ree ins cid sport or spousal exome le you wat wane thse Amun = PLEASE LIST VOUR BANK AND CREDIT REFERENCES ‘YOUR BANKS) iste Branch Type ot Acct. Acct Number i : YOUR DRIVER'S LICENCE NUMBER _STATE YOUR VEHICLE MAKEAMODEL__ Yeu SECOND VEHCLE MAKE?MODEL,_ Yes aaa OTHER VECHILE HAVE YOU EVER: Filed for bankruptcy? C1No Yes Beencvised fom ensney? No Oven ‘Willi or nteoalyrefisedtopay ret when de? Py NO py Ye Peas give any adcitonl informatica which mig hep management evaluate this application ——conTINtE OVERA mnagsment hasan questions about his applization, Plas ive PHONE NUMBERS whore you can he oct DAY PHONE(S). NIGHT PHONES hereby apply teas he above decribed premise forts term nd yon the ccniton above st fo sd age thatthe rent to be payable the FIRST ___day of each month in advance. Asan inducers 1 the Ove ofthe property and tthe pen io accept hs aplication, | warn hat al statements above set forth are our however. should any statement made above be a misreprescattion or ate wuesatemon of Fes, $100.00 ‘vl be eained 1 fs the agents cas te, and eos processing my apt, heey deposit 2 camest mane tobe refunded to mei this aplication is ot acpi within snes banking Upon asepance ois applicaon. is depot hal be reais as part of the sect deposit. When so approved and asepld Vag to exstts aes fe "ons before possession is give and to ay the balance ofthe secur deposit Win husness banking da afer Bein otiied of ecoplance othe depos wil be orited x lauded damages in payment te agents he ance in proesing fy ng and spliatin, inching making necessary investigation my crt, career, and repaaton Ith pation i not pprved and acepied by he owner ‘of agent the depos wl be funded, be applicant hereby wang sy lim fr damages by rnson of nonascptancs which comer o is gen my jest without ting any reason oro doing. Roeaaabet | ‘The apolatio formation provided ty yon maybe wed tobi fenantsreeing report te mame aed addres of he consumer reporting _sgency or ayentes hat wl embed wo obinn sueh report Ware: Porat eer sta el ons we tke adverse eton agaist you onthe bas of information costae in tenant screening report, we must nly vow tt such neon ‘vas taken and supply you withthe pane and adres ofthe commer reporting agency at provided the eran crecing report om he Tass of whieh such ton was takes; {Magy adverse avon ite against you based on information contained fe a tenant sereeing report, you have the right to inspect and recived free copy ofthat report by contaetiag the consumer reporig agency: 5 _ Every tenn or prospective eat raed fo on Be lean seeing rapt om a san consamer reporting agency annually in dutian ox ereai report that shouldbe obtaied fem wncinmolerditeportcom; and ‘4. Bvery tenant or prospective tenust may dspote insecure or incorrect inforaution contained in a tenant ereenlng report lect with the ‘consumer reporting agen. ‘he shove infomation tthe est of my knowledge, and cote. ‘Signe of Apis, perce Date Signed, Devos oF RECEIVED BY (NAME) _ TS APPLICATION FORM RECEIVED BY (NAME, — __ _ (Gecaer [REQUIREMENTS NEEDED WHEN SUBMITTING APPLICATION 1. S100 NON-REFUNDABLE APPLICATION PEE (MONEY ORDER OR }F EMPLOYMENT (VERIFYING INCOME & LENGTH EMPLOYED) RECT PAY SDS eee ‘COPY OF CURRENT LEASE & THREE () RECENT RENT RECIEPTS i STATEMENT _ 1 (REET TTA PAPERS WHT WE FORT Comms A charge of $100.00 for services and cost incurred to evaluate your potential tenancy is rendered by applicant. The applicant acknowledges that this charge is non-refundable whether accepted or rejected for tenancy. PLEASE MAKE MONEY ORDER PAYABLE TO: PARKOFF OPERATING CORP. Is our policy ta maintain full compliance with the non discrimination regulations defined in all applicable state, local, and federal housing law including but no limited to, Title VII ofthe Civil Right Act of 1968, The Fair Housing Amendments ‘Act of 1988, Section 504 of the Rehabilitation of 1973, Title 110 ofthe Americans with Disabilities Act (ADA) ‘As part of our commitment we do not indicate a preference, epply@ limitation or in any way discriminate against person based upon race, color, religion, sex, sexual preference, national origin, familial status/disability APPLICANT SIGNATURE This Application _() APPROVED By . = _ Dat Navies, Applicant Notified byPARKOFF ORGANIZATION 98 Cuttermill Road Suite 4448 Great Neck, New York 11021 (516) 487-6790 (718) RIDER TO LEASE APPLICATION 5046 PLEASE TAKE NOTICE, that this Rider to Lease Application is considered to be an integral part and made a part of the Lease Application under which the applicant(s) below named is applying for a rental apartment from the Parkoff Organization. It is applicants obligation to provide all documentation required herein, and the Parkoff Organization reserves the right to deny tenancy to any applicant who fails to fully comply with the requirements herein: 1 2, ‘Tenant's full name (print): Date: List the complete names and dates of birth of cach person who will occupy the apartment for which you are applying: Name Date of Birth For cach person listed in number 2 above, who is under the age of seven (7) years of age of the date of this rental application, provide a complete copy of the results of medial screening for lead paint exposure dated within one (1) year of the above date. Ifa child has not been previously screened for lead exposure, the applicant is required to submit each such child who has attained at lease six (6) months of age to medical lead screening as a condition of this application. The Parkoff Organization is to be provided with a complete copy of screening results as a part of the rental application. 4, Ibis agreed that applicant will notify the Parkoff Organization at the address listed above, in writing should there be any change during the lease term in person occupying the apartment being applied for Tenant's SignatureGUARANTOR, LETTER hereby agree to guarantee and be jointly and sever y liable for the pays nt of rent for apart- ment number at Guarantor represents and acknowledges and understands that this guarantee shall remain in full force and effect for as long as the tenants executing the lease. dated rem: possession of the subject premises Guarantor further acknowledges and represents that in the event th tenants herein fail or refuse to execute renewal leases on a timel basis, thet guarantor shall remain jointly and severally liable all damage to the subject premises and for use and occupancy payments while the tenants remain in possession. Whether or not there is a and enforceable lease, it is being understood that the failure to e ‘tea renewal lease on a timely basis shall create a month to mont tatutory tenacy. Giarantor Signature bate Guarantor Smployer Present Home Address Business Address Wome Telephone Naw Business Telephone Number Social Security mba: Rpprox. Annual facowe Bank Name. as. Ref. (to verity employt ountant's Name and Phone #)