ADDRESS APPLYING FOR (Include Unit#)

Please complete in full. This form does not obligate either party to the performance of a contract for leasehold property. It is purely to gather information and does not constitute an offer to lease property, or any negotiation for such purpose.

APPLICANT

Personal Information

EDUCATIONAL BACKGROUND

EMPLOYMENT/BUSINESS

Financial Information

ASSETS (I or We Own)

Stocks and Bonds(please list below):

Real Estate (please list below):

MONTHLY INCOME

Other Income (describe):

CO-APPLICANT/SPOUSE

Personal Information

EDUCATIONAL BACKGROUND

EMPLOYMENT/BUSINESS

Financial Information

LIABILITIES (I or We Own)

Accounts Payable to (Give Name):

Other Liabilities:

MONTHLY EXPENSES

Other
(include installment payments other than real estate):

STOCKS AND BONDS

MISCELLANEOUS QUESTIONS

Please make sure to complete the Financial Information section. If you have a different format which was prepared by your accountant, it will be ac- ceptable by the landlord in lieu of our financial statement. If you are signing the lease as a corporation, please include corporate information as well. In addition, please include copies of your last two years tax returns.

It is understood that the purpose of this application is to gather general information for the purpose of procuring the establishing credit from time to time with you and to induce you to permit the undersigned to become indebted to you and is in no way binding upon either Specialized Realty, Inc. or its agents or representatives of the applicant. It is, however, understood that the applicant supplies the information contained herein to the best of his or her knowledge and ability.

By submitting this application, I/We hereby authorize Specialized Realty, Inc. or whomever they may appoint, or any Landlord, credit bureau, other investigation agency, or other financial institution, to investigate criminal background, credit history, financial responsibility, ability to pay rent, residential history, and the references and statements submitted to obtain information regarding my/our employment and back- ground, as needed to process our application. It is understood that a non-refundable $35 application processing fee is required per applicant. This application shall become a part of any lease for this unit.

The undersigned certifies that the above statements (or in lieu thereof, the attached statement, as the case may be) and supporting schedules, both prints and written, give a full, true and correct statement of the financial condition of the undersigned as of the date indicated.

PAYMENT

There’s a Non-Refundable ($35.00) processing fee for your Rental Application. Application will be submitted after payment.