P.O. Box 271 RUSTON, LA. 71273-0271
318-245-5459 Fax 318-254-1198
Please fill out this form, print it and fax to: 318-254-1198. This form cannot be submitted via the Internet.
Social Security #:
Drivers License #: (mail or fax copy of license with application)
(If Student, est. graduation date:)
Place of Employment:
Employment Phone #:
Landlord Phone #:
Current Phone #:
Parents Phone #:
Reason for leaving current address:
Names of People includes as Tenants: (Limit 2 people)
Preferred move-in date:
List Current Income Amount, Supervisor and Phone # for Verification:
I understand that by submitting a rental or deposit payment for an apartment, that I have committed to a one year agreement, subject to application verification, credit/background check, and approval, and I will lose my rental or deposit payment if I change my mind. Rental or deposit monies will be refunded if the application is not approved. I understand that the lease is available online to read and approve before I make this commitment. I give my permission for a credit/background check and employment/income verification for the purpose of this rental.
(SIGNATURE REQUIRED-may be evidenced by facsimile)
WE RESERVE THE RIGHT TO REFUSE SERVICE TO ANYONE.
Please fill out this form, print it and fax to: 318-254-1198. This form cannot be submitted via the Internet..