Village Square Rental Application

Rental Application
APPLICANT INFORMATION
Full Legal Name *

First Name Middle Name Last Name Suffix
Birth Date *

Month Day Year
Present Address
License #
Social Security # *
E-mail *
Primary Phone Number *

- Area Code Phone Number
Secondary Number *

- Area Code Phone Number
Fax Phone Number

- Area Code Phone Number
Anticipated Move-In Date *

- Month - Day Year
PERSONAL REFERENCES
First Reference *

First Name Last Name
Phone Number *

- Area Code Phone Number
Second Reference

First Name Last Name
Phone Number *

- Area Code Phone Number
Third Reference

First Name Last Name
Phone Number

- Area Code Phone Number

Additional Information (Guarantor)
Full Legal Name

First Name Middle Name Last Name Suffix
Birth Date

Month Day Year
License #
Social Security #
Primary Phone Number

- Area Code Phone Number
Secondary Phone Number

- Area Code Phone Number
E-mail

Present Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Signature
Signature
Should be Empty: