PERSONAL INFORMATION/ Property of Interest (List Here): 2363 First Street, La Verne Ca. 91750 #First Name Middle Last DOB: SSN:

Present Address City/State/Zip

Cell Phone Email Class Rank: (Freshman, Sophomore, Junior, Senior, Grad)

PARENTAL and or GUARANTOR INFORMATION (REQUIRED) First Name Middle Last

Address City/State/Zip

Email Phone-Cell Social Security #

Relationship to Student: Father Mother Legal Guardian Other:

PROPOSED ROOMMATES 1. First Name Last Name Phone-Cell

Email

2. First Name Last Name Phone-Cell

Email

3. First Name Last Name Phone-Cell

Email

RENTAL HISTORY- if you currently live on campus, specify ‘campus’ for ‘landlord’ (REQUIRED)Current Landlord Landlord Phone

Reason for leaving Is your current rent up to date?

YES NO

Have you ever been evicted?

YES NO

Have you ever been sued for property damage?

YES NO

Have you ever been sued for rent?

YES NO

Is the total move-in amount available now (rent & deposit)?

YES NO

Have you ever been convicted or plead guilty or no contest to a felony, sex-related crime, or misdemeanor assault against another person?

YES NO If you answered yes to any of the above, please explain:

VEHICLE(S) INFORMATION – if no vehicle, please state here:Year Make Model Color Plate # State

Year Make Model Color Plate # State

STUDENT RENTAL APPLICATION Please fill out this form COMPLETELY and sign where indicated. $100 per applicant

REV 1/18/2019

EMERGENCY CONTACT First Name Middle Last

Address City/State/Zip

Email Phone-Cell Phone-Home

Relationship to Student: Father Mother Legal Guardian Other:

Applicant authorizes La Verne Landing, LLC to contact landlords and any other sources deemed necessary to investigate applicant. All information is true, accurate, and complete to the best of the applicant’s knowledge. La Verne Landing, LLC reserves the right to disqualify the tenant if information is not as represented. Any person or firm is authorized to release information about the undersigned upon presentation of this form or a photocopy

of this form at any time. Applicant/Parental and or Guarantor hereby authorizes to obtain credit report on parental/guarantor, applicant, warnings about the individual which may include, but not limited to, bad checks, fraud warnings and employment and tenancy history.

The undersigned do herby acknowledge that La Verne Landing, LLC represents the Owner in this transaction. Property will be shown and made available to all persons without regard to race, color creed, religion, national

origin, sex, familial status, handicap, or elderliness in compliance with all applicable federal, state, and local fair

housing laws and regulations.

________________________________________________

Applicant’s Signature Date

________________________________________________ Parental and or Guarantor Date

REV 1/18/2019

620 Arrow Highway, La Verne, Ca 91750 (909) 599-4262 bianca@lavernelanding.com www.lavernelanding.com

CANCELLATION FORM Date: _________________ I am submitting the Security Deposit in the amount of $____________in the form of a personal check/money order to reserve the apartment unit located at 2363 First Street #_______, La Verne, Ca, 91750 from__________________________________. I understand this payment is for Security Deposit only. In the event I do not take possession of the Apartment or cancel my reservation, I have read, understand and agree to the following cancellation policy. CANCELLATION:

(a) If applicant cancels/doesn’t sign the lease before March 1, 2019 after signing this Cancellation Form, we will refund the full deposit.

(b) If a lease isn’t signed by March 1, 2019 tenant can opt to remain on the waiting list but is not guaranteed the requested unit. If no unit is assigned by July 31, 2019 a return of refund will be given.

*Security Deposit refunds will be processed after cancellation in 21 days. Any fees convenience fees paid will not be refunded. **In the event applicant decides to cancel, it must be put in writing and mailed to 620 S. Arrow Highway, La Verne, CA 91750. The cancellation will take effect on the date notice was mailed and postmarked by the U.S. Postal Service. ____________________ _________________________ __________________________ Name (please print) Signature Date (Current tenants must sign, acknowledging and accepting the cancellation terms)

(Proposed) Move in Date: _________________ *The Move in date is subject to change according to the current lease terms and conditions*

Contact Phone Number : _______________ Referred by: _____________________

By checking these boxes, it does not automatically guarantee an affordable bedroom. La Verne Landing, LLC reserves the right to properly investigate the supporting documents. Once approved supporting documentation will be submitted to the City of La Verne for final approval.

AFFORDABLE HOUSING CHECKLIST

1. DETERMINING WHO QUALIFIES

☐ Do you file your own taxes? If you are a dependent on someone else’s taxes, there income will be counted.

☐ Is your total income less than $57,715.00? (Gross Wages, welfare assistance, and frequent deposit)

2. COLLECT INCOME DOCUMENTATION (NEEDED)

☐ Pay Stubs

☐ Third-party verification (Credit Check)

☐ Checking bank statements (all pages, 6 months)

☐ Savings bank statements (all pages, 1 month)

☐ Certified copies of tax returns (Can be acquired by submitting IRS Form 4606)