People Planning to Live at Location

Name of ALL people who will be living here:

Name Date of Birth Relationship Social Security Number or T.I.N.
Address History
Employment History
Additional Information
I understand that if the unit is occupied or not ready.
and the application processing will begin immediately.

I do hereby request and authorize this company, any person or persons, each employer or former employer, credit bureau, or any firm or corpo-ration referred to in or discovered by the use of this application, to give answers to any questions or inquiries in connection with this application or tenancy. I authorize Acc-Sell to obtain resident screening information which may include but not limited to credit history, sexual offender his-tory, criminal history, and terrorist history. Acc-Sell is acting exclusively as an "Owner's Agent" through Century 21 Affiliated in this rental pro-cess. Applicant understands that upon approval the Earnest Payment must be paid immediately to hold the unit for up to 21 days.

I have read, understand, and agree with the application requirements listed on the back of this application or on the website.