Online Application

Completed application is required from every individual occupant aged 18 or older.  Please type "N/A” for fields that do not apply to you. No application fee.

Please complete the form below

Address 1
Address 2
Applicant
Full Name *
Full Name
Date of Birth *
Date of Birth
Phone Number *
Phone Number
Address 1
Address 2
City
State/Province
Zip/Postal Code
From-To
Are you currently in a lease? *
Have you given a notice? *
Landlord/Manager's Phone Number *
Landlord/Manager's Phone Number
Landlord/Manager's Fax *
Landlord/Manager's Fax
Address 1
Address 2
City
State/Province
Zip/Postal Code
From-To
Landlord/Manager's Phone *
Landlord/Manager's Phone
Additional Occupants
List every person, including children, who will live with you:
Additional Occupant Name
Additional Occupant Name
Additional Occupant Name
Additional Occupant Name
Additional Occupant Name
Additional Occupant Name
Applicant's Employment History
List past 2 employers
Address 1
Address 2
City
State/Province
Zip/Postal Code
Employer's Phone Number *
Employer's Phone Number
Name of Supervisor *
Name of Supervisor
From-To
Address 1
Address 2
City
State/Province
Previous Employer's Phone *
Previous Employer's Phone
Name of Previous Supervisor *
Name of Previous Supervisor
From-To
Applicant's Credit and Financial Information
$
Applicant's Miscellaneous Information
Do you have any pets? *
Do you smoke, or use tobacco in any form? *
Would you place a waterbed on the property? *
Have you ever been a part of any bankruptcy proceeding? *
Have you ever been named party to any lawsuit? *
Have you ever been evicted, or asked to leave any property? *
Have you ever been convicted of, or plead guilty to, any crime? *
Have you ever been arrested? *
I certify that all the information given above is true and correct and understand that my lease agreement may be terminated immediately if I have made any false, misleading, or incomplete statement in this application. I hereby authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers, and personal references, and I indemnify them and the Rieger Realty, L.L.C. from any claims brought forth as a result of providing information in relation to this application.
Applicant's Signature *
Applicant's Signature
Date *
Date
Please Note: Applicant must read below. By completing Applicant's Signature fields, applicant is providing acknowledgment of the Release of Information Statement.