Application Agreement New Application Print Completed Application Pay Application Fee

I have read and agree to the Application Agreement. Click Here to read Application Agreement.
Application Fees are 75.00 per person over the age of 18 in the household.
(NOTE:  An application will not be processed until fees are received.)
Property Information
Property Address:
Date you will take occupancy:
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Date Submitted

11-22-2024
Applicant type: Individual   Co-Applicant
Applicant Information
First:
Middle Initial:
Last:
Date of Birth:
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SSN:
Home Number:
Cell Number:
Email:
Driver License #:

State:
Expires: Click Here
Automobile Information
Make:
Model:
Year:
Color:
License plate#:
State:

Make:
Model:
Year:
Color:
License plate#:
State:

Any other name(s) used (including maiden name): 
Residential History
Current Address
Street1:
Street2:
City:
State: Zip:
Residency: Rent   Own
Previous Address
Street1:
Street2:
City:
State:
Zip:
Residency:
Rent   Own
Employment Information
Are you Retired?
Yes No
Current Employer
Employer:
Address:
City:
State:
Zip:
Phone Number:
  Ext:
Supervisor Name:

Supervisor Number:
  Ext:

Your Title/Position:

Monthly Income:
Start Date:
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Are you Self-Employed?
Yes No
Previous Employer
Employer:
Address:
City:
State:
  Zip: 
Phone Number:
  Ext:
Supervisor Name:

Supervisor Number:
  Ext:

Your Title/Position:

Monthly Income:
Start Date:
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End Date:
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Applicant Questions
Have you ever been asked to move out of a residence?
Yes   No

Have you ever been party to an eviction?
Yes   No
Are you a registered sex offender?
Yes   No
Have you or any member of your household been convicted or pleaded no contest to a felony?
Yes   No


Do you have liquid furniture? (i.e. waterbed)
Yes   No

Do you have renter insurance?
Yes   No
Have you ever filed bankruptcy?
Yes   No
Have you ever had any collections?
Yes   No
Pets
Do you have Pets?
Yes   No
Other Occupants (The maximum is six.)
Please list all people who will reside in the residence: 

Emergency Contacts
Emergency Contact
First:
Middle:
Last:
Home Phone:
Cell Phone:
Street1:
Street2:
City:
State: Zip:
Nearest Relative (Not residing in the property.)
First:
Middle:
Last:
Home Phone:
Cell Phone:
Street1:
Street2:
City:
State: Zip:

Financial Information
Bank Name Account Type Phone
Credit Reference Name Account Type Balance




Do you own a home or other real estate? Yes   No

Additional Income Source Monthly Income
Pension
Social Security and/or SSI
Alimony
Child Support
AFDC/Government Assistance
Unemployment Compensation
Other
Additional Comments or Notes
Application Completion

DISCLOSURE AND AUTHORIZATION

The undersigned declares that the information on this rental application is true and correct, and understands that false statements may result in rejection of this and any future applications for housing we manage.  The undersigned does further understand that all persons or firms associated with Island Realty may freely give any requested information concerning me.

I also hereby authorize Island Realty to verify my past and present employment earnings records, bank statements, previous residences and/or any information given for the purposes of renting and/or leasing through Island Realty including but not limited to a credit check.  I further understand and agree that Island Realty will rely upon this rental application as an inducement for entering into a rental agreement or lease and I warrant that the facts contained in this application are true.  If any facts prove to be untrue, Island Realty may terminate my tenancy immediately and collect from me any damages incurred including reasonable attorney fees resulting there from.  Island Realty welcomes all applicants and supports fair housing.  We do not refuse to lease or rent any housing accommodations or property nor in any other way discriminate against a person because of sex, marital status, race, creed, religion, age, familial status, physical or mental handicap, color or national origin.

Investigational Background Search Disclosure

Island Realty conducts applicant screening on persons applying to live in our managed properties, such screenings may include criminal background investigations.  Prior to acceptance of an applicant, we may use an independent consumer reporting agency to search public records which may contain criminal background information regarding the applicant.  Island Realty will determine if the criminal background information pertains to the applicant and if the report indicates that one or more such felony and or misdemeanor records were found.  We will then compare the records to our established acceptance policies to determine whether or not the applicant may be accepted.  If your application is declined based on the discovery of public records that indicate an unacceptable criminal background, you will be given the name, address, and telephone number of the consumer reporting agency that provided the criminal background report.  An applicant who is declined based on a criminal background may obtain a free copy of the report and may initiate a reinvestigation to have any erroneous information contained in the report corrected.  The consumer reporting agency will advise you of the procedures that you should follow in order to do so.

Valid Photo Identification must be presented prior to final approval of this application.

I, the undersigned Applicant, agree to the above terms and do hereby swear (or affirm) that the information supplied herein is true and complete, to the best of my knowledge and belief.  By clicking "Apply Now" you agree to the terms stated above.  Please enter your full name to signify your digital signature, thereby confirming that you have read and agree with all the above statements and have provided complete and accurate information.  Applicant authorizes verification of references given and declares that the statements made in this application are true and correct and agrees that the landlord may terminate the contract entered into in reliance on any misstatement made in this application.


APPLICANT SIGNATURE: 




   
Web:  www.islandrealty.com       E-mail:  [email protected]
Database Info:  ISLANDRY_102022  Island_Realty_New