By signing below and submitting this form you consent to the collection, use, and disclosure of your personal information for the purpose of determining the Applicant for the leasing of the premises, or making use of the personal information as the Landlord and/or agent of the Landlord deems appropriate.

By submitting this form, The Applicant represents that all statements made above are true and correct. The Applicant authorizes the verification of the information contained in this application and information obtained from personal references. This application is not a Rental or Lease Agreement. In the event that this application is not accepted, any deposit submitted by the Applicant shall be returned.