Centra Associates - Historic Philadelphia Brownstone Apartments

Apartment Information Building:

Personal Information First Name:

Middle Initial:

Last Name:

Primary Phone #:

Email Address:

You must be at least 18 years of age to apply for an apartment with Centra Associates.

Date of birth:

Social Security #:

Drivers License #:

State Issued #:

Occupants Total Number of Occupants:

Please provide the full names of ALL other occupants.

Occupant #2:

Occupant #3:

Occupant #4:

Pets

Please provide the number and type of pets owned by ALL occupants.

Total number of pets:

Pet Type 1:

Number:

Pet Type 2:

Number:

Pet Type 3:

Number:

Pet Type 4:

Number:

Your Rental History

Please provide your rental history for the last 3 years (starting with the most current).

Current Residence:

Current Address:

Date Moved In:

Reason for Leaving:

Owner/Agent:

Phone #:

Last Residence:

Previous Address:

Date Moved In:

Date Moved Out:

Reason for Leaving:

Owner/Agent:

Phone #:

Previous Residence:

Previous Address:

Date Moved In:

Date Moved Out:

Reason for Leaving:

Owner/Agent:

Phone #:

Your Employment Information Employment Status: Full Time Part Time Student Retired Not Employed

Current or Most Recent Employer:

Employer Name:

Employer Address:

Employer Phone:

Date Start:

Currently Empl.: This is the current employer

Position:

Supervisor:

Gross Monthly Pay: $

Gross Household Pay: $

Previous Employer:

Employer Name:

Employer Address:

Employer Phone:

Date Start:

Date End:

Position:

Supervisor:

Bank Information and Credit References

Bank 1:

Bank Name:

City/State Branch:

Telephone:

Account Type:

Bank 2:

Bank Name:

City/State Branch:

Telephone:

Account Type:

Reference 1:

Credit Reference:

City/State:

Telephone:

Account#:

Reference 2:

Credit Reference:

City/State:

Telephone:

Account#:

Final Evaluation Questions

Have you or any of your co-applicants ever:

Been sued for non-payment of rent? Yes No

Been evicted or asked to move out? Yes No

Been sued for damage to rental property? Yes No

Broken a Rental Agreement or Lease? Yes No

Declared Bankrupcy? Yes No

Please give any additional information that might help management evaluate your application:

How did you hear of Centra Associates?

If management has any questions about your application, please provide numbers where you can be reached.

Day Phone:

Night Phone:

In Case of Emergency, Please Contact:

Full Name:

Full Address:

Home Phone:

Work Phone:

Rental Agreement Disclaimer

Disclosure Statement:

I hereby apply to lease the above described premises for the term and upon the conditions above set forth and agree that the rental is to be payable the 1st day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application, I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, 10% of the deposit will be retained to offset the agent's cost, time, and effort in processing my application.

I hereby deposit one month's rent as earnest money to be refunded to me if this application is not accepted within 5 business banking days. Upon acceptance of this application, this deposit shall be retained as part of the security deposit. When so approved and accepted I agree to execute a lease for 12 months before possession is given and to pay the balance of the security deposit within 5 business banking days after being notified of acceptance, or the deposit will be forfeited as liquidated damages in payment for the agent's time and effort in processing my inquiry and application, including making necessary investigation of my credit, character, and reputation. If this application is not approved and accepted by the owner or agent, the deposit will be refunded, the applicant thereby waiving any claim for damages by reason of nonacceptance which the owner or his agent may reject without stating any reason for so doing.

I RECOGNIZE THAT AS A PART OF YOUR PROCEDURE FOR PROCESSING MY APPLICATION, AN INVESTIGATIVE CONSUMER REPORT MAY BE PREPARED WHEREBY INFORMATION IS OBTAINED THROUGH PERSONAL INTERVIEWS WITH MY NEIGHBORS, FRIENDS AND OTHERS WITH WHOM I MAY BE AQUAINTED. THIS INQUIRY INCLUDES INFORMATION AS TO MY CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS, AND MODE OF LIVING. I UNDERSTAND THAT I MAY HAVE THE RIGHT TO MAKE A WRITTEN REQUEST WITHIN A REASONABLE PERIOD OF TIME TO RECEIVE ADDITIONAL, DETAILED INFORMATION ABOUT THE NATURE AND SCOPE OF THIS INVESTIGATION.

APPLYING FOR AN APARTMENT WITH CENTRA ASSOCIATES THE FOLLOWING IS REQUIRED:

A Completed rental application from each applicant.
Photo I.D. from each applicant and co-signer (if applicable).
A Security Deposit in the amount of one month's rent (certified check or money order) made payable to: Centra Associates
A $50.00 application fee per applicant and co-signer (if applicable) this fee is non-refundable.
Proof of current income (W2 or 1040 form and 2 most recent paystubs) if you are unable to provide this information, you may show an offer letter from your employer with your annual salary and start date on company letter head. BANK STATEMENTS ARE NOT AN ACCEPTABLE FORM OF INCOME.
A signed W-9 Form provided by Centra Associates.
If a Co-Signer is needed, then the co-signer must follow the same procedures listed above in order to be approved.
Cats and Small dogs (under 40lbs) are accepted. Rent will be an additional $10.00 each month, per pet.
A refundable pet deposit of $100.00 per pet is required.
All tenants must obtain Renters Insurance and supply Centra Associates with a copy of the insurance policy prior to move in.

I understand that after completing the application process and being accepted if I do not take occupancy of the apartment, that it will result in forfeiture my security deposit.
I understand that once accepted for an apartment by the landlord and a move-in date has been established that the process is final and I will be responsible for rent beginning on that date.
I understand the decision of acceptance or denial of my application is the landlord's final decision and I agree to waive any claim for damages by reason of non-acceptance which the landlord may give.
I understand that if accepted, I must sign my lease and my last month's rent must be paid within (7) days of acceptance of this application without exception. Failure to do so will result in forfeiture of my security deposit.

Applicants Credit Check Consent

I/we authorize that the information on my rental application is correct and complete and hereby authorize Centra Associates, or its agents, to obtain information it deems necessary for the purpose of processing my application. I understand that such information may include, but not limited to, credit report/history, civil or criminal information, records of arrest, rental history, employment/salary details, and/or other necessary and relevant information. I hereby expressly release Centra Associates, or its Agents, and any procurer or furnisher of information, from any liability what-so-ever in the use, procurement, or furnishing of such information, and understand that my application information may be provided to various local, state, and/or federal government agencies including without limitation, various law enforcement agencies. I also understand that my application fee is non-refundable, even if my application is denied.

By clicking the complet button below, you confirm that the information above is to the best of your knowledge is true and correct, and have read and agree completely with the disclaimer, and give Centra Associates my full permission to complete a credit and background check on myself.

Thank you for your application.
It will be reviewed and we will contact you shortly.

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