DPN Deerfield Pines North Assoc, Revision: C.

FORM 4.2.1.6 Standard Lease / Occupancy Form Date: 05/06/2014

INSTRUCTIONS F O R OWNERS WISHING T O L E A S E T H E I R APARTMENTS OR APPLY F O R OCCUPANCY APPLICATION

S E A S O N A L L E A S E / O C C U P A N C Y F O R M

This Leasing and/or Occupancy Application Form must be obtained by owners prior of leasing their apartments and for guests (roommates) staving longer then 60 days with Owners or Renters. This form must be completed in full by owner and prospective lessee and submitted to the Board of Directors 30 days prior to expected leasing date.

Occupancy prior to approval is strictly prohibited.

Leasing must be for a minimum of three (3) months and not for more than two (2) years. Only three (3) month rental will be allowed each twelve (12) month period.

A $100.00 processing fee must accompany this application. For International Renters a $250.00 processing fee must accompany diis application.

• One (1) bedroom apartments restricted to 2 residents.

• Two (2) bedroom apartments restricted to 4 residents.

• All applicants must supply a Photo LD. (driver license, State LD. , government issued L D . etc.). A color copy of this photo identification(s) must be submitted and kept on file with the application. Signature(s) must match the I.D. signature provided.

No pets are permitted in Deerfield Pines North.

Owners and/or Residents will be notified after all completed documents have been received and verified. An appointment for an mterview by a Screening Committee consisting of Board members for lease and occupancy will be made to meet with prospective lessee or occupancy applicants. This process can take up to tfiirty (30) days, and if references are out of town, could take longer.

Owners must provide lessee with a copy of the By-Laws and Rules and Regulations.

A five hundred dollar ($500.00) security deposit is required and wUl be returned to the owner at the end of the lease. Owners should advise their tenants and guests of all Rules and Regulations of Deerfield Pines North Association, and said owner wiU be held entirely responsible for the conduct and behavior of their tenants and guests.

Board of Directors will notify owner within 14 to 30 days of approval of disapproval.

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DPN Deerfield Pines North Assoc. Revision: B

FORM Seasonal Lease / Occupancy Form Date; 2/11/2011

O W N E R A P T # P K G #

E-mail of Owner/ Landlord:

Phone #:

P R O P O S E D L E S S E E / T E N A N T :

A D D R E S S :

S O C I A L S E C U R I T Y #:

T E L E P H O N E : R E S . # BUS#

C E L L #

L E N G T H O F L E A S E : F R O M T O

N A M E S O F I N D I V I D U A L S W H O W I L L R E S I D E I N A P A R T M E N T

No. of Cars: Year Make and Model

Musical instruments:

List names of members of your immediate family (children and grandchildren) and their ages: 1. 4.

2. 5.

3. 6.

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DPN Deerfield Pines North Assoc. Revision: B

FORM Seasonal Lease / Occupancy Form Date: 2/11/2011

OWNERS STATEMENT

I U N D E R S T A N D T H A T I A M P E R S O N A L L Y L L V B L E AND R E S P O N S I B L E F O R T H E A C T S O F T H E A B O V E SAID L E S S E E / O C C U P A N T S W H I L E T H E Y A R E R E S I D I N G O N T H E P R E M I S E S .

Lessees / Occupants have been advised of all rules and regulations governing residents of Deerfield Pines North. The lessee / occupants agree not to sub-rent and to observe and comply with all rules and by-laws of the association.

I understand that the acceptance for lease of an apartment at Deerfield Pines North is conditioned upon the total completion, truth, and accuracy of this application and upon the approval of the Board of Directors. Occupancy prior to approval is strictly prohibited.

O W N E R S S I G N A T U R E D A T E :

This lease made on the d̂ay of 2̂0

By and between , hereinafter referred to as

Landlord, and , hereinafter referred to as tenant.

SEASONAL LEASE / OCCUPANCY APPLICATION FORM

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DPN Deerfield Pines North Assoc. Revision: B

FORM Seasonal Lease / Occupancy Form Date: 2/11/2011

W I T N E S S E T H :

I n consideration of the mutual covenant hereinafter contained, the Landlord and Tenant agree that the Landlord leases to the Tenant, Apartment # in Deerfield Pines North Condominium, which is located at 959 S .E . 2^^ Avenue, Deerfield Beach, Florida.

I N W I T N E S S W H E R E O F , T H E P A R T I E S H E R E T O H A V E E X E C U T E D T H I S L E A S E AND A F F I X E D T H E I R S E A L S T H E D A Y AND Y E A R F I R S T W R I T T E N A B O V E .

S I G N E D , S E A L E D AND D E L F Y E R E D

In the presence of:

Landlord: ALS to Landlord

Tenant: As to Tenant

Recommendation by the Screening Committee:

Approve: Yes U > U ^y: Date: Screening Committee

Approved by the Board of Directors Deerfield Pines North Association Inc.

On: for the period listed on the attached lease.

By (DPN Seal) Board of Directors

SEASONAL LEASE / OCCUPANCY APPLICATION FORM

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DPN Deerfield Pines North Assoc. Revision: B

FORM Seasonal Lease / Occupancy Form Date: 2/11/2011

I understand that the Board of Directors of the Deerfield Pines North Association may institute such investigation of my background, as they may deem necessary. Accordingly, I specifically authorize the Board of Directors or their agent to make such investigation and agree that the information contained in this application may be used in same investigation, and that the Board of Directors and officers of the Deerfield Pines North Association itself shall be held harmless from any action or claim by me in connection with the use of information obtained herein or any investigation conducted by the Board of Directors.

I hereby agree for myself and on behalf of all parties who may use the apartment which I seek to lease that I will abide by the rules contained in the By-Laws and Rules and Regulations and rules which are or may in the future be imposed by the Deerfield Pines North Association.

I n making the foregoing application, I am aware that the decision of the Deerfield Pines North Association will be final.

In case of refusal, the Board of Directors will not be obligated to give any reason for such decision. I agree to be governed by the determination of the Board of Directors.

Any breach of these said Rules and Regulations may be used to give the Board of Directors the means to cancel your lease and request you to vacate the apartment.

By signing this document, I do hereby agree to abide by the terms set forth.

S I G N E D T H I S D A Y O F 2̂00

L E S S E E / O C C U P A N T S I G N A T U R E :

L E S S E E / O C C U P A N T S I G N A T U R E :

S E A S O N A L LEASE / OCCUPANCY AUTHORIZATION FORM

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DPN Deerfield Pines North Assoc, Revision: B

FORM Seasonal Lease / Occupancy Form Date: 2/11/2011

Applicant(s) understand that as a part of our procedure for processing your application, an outside agency, Veristat Information Services, Inc., will research from the information given and present their findings to the Screening Committee for review. Applicants must complete and sign the attached outside agency (Veristat) application for occupancy and that all information given is true and correct. The authorization to release information for residence, credit, banking, employment, driver license history, criminal history or any other information pertinent to this application must be signed by the applicant(s)

Authorization to Release Information

You are hereby authorized to release and give to the below mentioned party(s), their attorney or representatives, any and aU information they request concerning my residence, banking, credit, employment, driver license history, criminal history or any other information in reference with my/our application made for occupancy.

Designated party: D E E R F I E L D P I N E S N O R T H C O N D O M I N I U M A S S O C I A T I O N I N C .

I hereby waive any privileges I may have with respect to the said information in reference to its release to the aforesaid party(s)

Date:

Applicant's Signature(s) Applicants Name(s) Printed

Page 6 of 6

Page 1 of2

D E E R F E L D PINES NORTH ASSOC.

APPLICATION FOR OCCUPANCY

THIS APPLICATION IS FOR MARRIED COUPLE/SINGLE PERSON ONLY. SINGLE PERSONS-fjPPLYlNG FOR THE SAME UNIT TOGETHER MUST FILL OLT SEPERATE APPLICATION FORMS. FILL IN ALL THE BLANKS. THIS APPLICATION MAY BE RETURNED IF NOT LEGIBLE AND FULLY COMPLETED. U S E B L A C K I N K P E N ONl,Y,

Date Lease Purchase Desired date of occupancy_ Unit s

Realtor Narr.e: Phone 5

_Bldg, #

Marital Starus: Married Single Divorced Widowed Phone #_

Your Name: Last J ' ^ •

SSN:

Spouse Name: Lasi:_

SSN;

Auto; Make_

Auto: Make_

Present address_

City

Landlord name_

Previous address_

City

Landlord name_

Previous addrsss_

City__

Landlord naine_

Driver license t:^

_M.]. . Date of Birth:.

State:

First M.l.

Driver license

Model Year Tag#_

Mode) Year Tag#_

RRSTDENT m^T-OBV (PAST 7 YEARS')

State

_Tclcphone

State

Telephone s_

State

_Telephone #

_Zip code;_

D3teofBirth_

State:

State:

State:

How lone

From To

_Zip code;_

From To

_2ip codc;_

U w - r ODD Blfaia 10:9544289415 P.2

D E E R F I E L D PINES NORTH ASSOC.

APPLICATION FOR OCCUPANCY

EMPLOYMENT HISTORY

Self Employed; Yes( ) No ( ) Retired: Yes ( ) No ( ) I f self employed name of business:.

Present Employer: Telephone number:

City:

Page 2 of2

From:

State

Det)t., or Position: _Super\'isor:_

Previous Employer:,

City: State:

_Telephone number;_

_Depc, or Position;

_Gross monthly income:,

From; To;

_Supervisor:_

Spouse's Employer,

City:

_Telephone number;. From:

State

Dept. or Position:, _Supervisor;_

Previous Employer:,

City:

_Telephone number:.

_Gross monthly income:,

F̂rom: To:

State: _Dept., or Position:, _Supervisor;_

Other income:

Referep.ce,

Reference

REFERENCES (no relatives)

_Honis phone

Home ohone

_Woric phone,

,Work phone_

Bank Name:

BANK R E F E R E N C E

_Teiephone # ; Acct.#, _How long:.

Mortgage: Yes ( ) No ( ) Mortgage Co.:_ _Telephone #_ Loans

CRIMINAL HISTORY

Have you ever been arrested? If yes. please explain:.

.Applicant(s) represents that all information given is true and correct. App!icant(s) understand thai as a part of our procedure for processing your application, an outside agency, VERISTAT INFORMATION SERVICES, INC., will research from the information given and present their findings to us for revieu.-. Tni.s research will include, but is not limited to, character, general reputation, credit, banking, driver license, Florida automobile tag information, residence, employment and criminal search. Applicant(s} agree not to hold the Association or its agent liable for any discovery or non-discovery of information or any actions taken as a result of this research. Tne hiring company and the agent will comply within the parameters of the (FCRA) Fair Credit Reporting Act and other laws as they pertain. Authorization is hereby given to release residence, credit, motor vehicle, driver license, employment, banking and criminal historv' or any other information pertinent to this application.

Applicant; Spouse:.