Lease Online

Applicant's Information
Please complete the entire form.  Your application is not complete unless it is signed and dated.
Note: Applicant must be 19 years of age in the State of Nebraska.
First Name:
Middle Name:
Last Name:
Date of Birth:
Place of Birth:
*Email Address:
Social Security Number or Green card/VISA:
State:
Driver's License Number (copy of license required at move in - if no license, state issued photo ID):
Issuing State:
*Select your community:

PLEASE COMPLETE LAST (3) YEARS OF RESIDENCY
Present Address - Street:
City:
State:
Zip Code:
County:
Home Phone:
Work Phone:
Landlord/Mortgagee Name:
Phone Number:
Length of Residency in Months:
Rent/Mortgage:
Landlord/Mortgagee Street Address:
City:
State:
Zip Code:
County:

YOUR PREVIOUS ADDRESS
Street:
City:
State:
Zip Code:
County:
Landlord/Mortgagee Name:
Phone Number:
Length of Residency in Months:
Rent/Mortgage:
Landlord/Mortgagee Street Address:
City:
State:
County:

YOUR PREVIOUS ADDRESS
Street:
City:
State:
Zip Code:
County:
Landlord/Mortgagee Name:
Phone Number:
Length of Residency in Months:
Rent/Mortgage:
Landlord/Mortgagee Street Address:
City:
State:
Zip Code:
County:

EMPLOYMENT INFORMATION
Current Employer:
Supervisor:
Street:
City:
State:
Zip Code:
PERIOD OF EMPLOYMENT
From:
To:
Phone Number:
Monthly Income:
Position:
Other Sources of Income:
Current Total Annual Income:

Previous Employer:
Supervisor:
Street:
City:
State:
Zip Code:
PERIOD OF EMPLOYMENT
From:
To:
Phone Number:
Monthly Income:
Position:

VEHICLE & PERSONAL INFORMATION
Vehicle Year:
Make:
Model:
License Number:
State:
Vehicle Year:
Make:
Model:
License Number:
State:
Emergency Contact #1 (Other than occupants):
Relationship:
Phone Number:
Complete Address:
Emergency Contact #2 (Other than occupants):
Relationship:
Phone Number:
Complete Address:

PERSON(S) OTHER THAN APPLICANT TO OCCUPY APARTMENT (A Guarantor or Person(s) of legal adult age living in the apartment are required to complete a Rental Application as well. Minors and/or children under the age of 19 are not required to complete Rental Application.)

Applicant's Name:
Total number of person(s) to occupy apartment:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Will anyone in your household require special living accommodations or have special needs?:
If yes please explain:
Has anyone from your household ever been evicted, sued for rent, sued for property damage or ever broken a lease for any reason?:
If yes please explain:
Has anyone in your household ever failed to pay a debt, rent or judgement?:
If yes please explain:
Have you, or anyone else who is to occupy the appartment, ever been convicted, pled guilty, no contest, received probation, deferred adjudication, court-ordered supervision, or pre-trial diversion for:
If yes please explain:
Do you own any pets?:
If yes, type of pet:
Lbs.:

How did you hear about us?:



If you listed Referral, Web Site, or Other, please give details here:

APPLICATION IS NOT COMPLETE UNLESS AUTHORIZATION FORM BELOW IS SIGNED AND DATED
I hereby make application to lease and agree that the rent is payable the first of each month in advance. As consideration, I paid a deposit and application fee. Balance of deposit to be paid upon execution of the lease unless otherwise stated in the lease. I understand that, in addition, my application fee will be retained, to offset The Pointe Management Company’s cost, time, and effort in processing my application. Upon acceptance of this application, I agree to execute a lease. I recognize that, as part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained regarding my credit history, employment history, criminal history, and housekeeping history. This inquiry includes information as to my character, 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. Any false or incomplete information will result in the denial of your application. If discovered after you are approved and have moved in, we reserve the right to terminate your tenancy. In the event this application is accepted, but I subsequently refuse to sign a lease and/or take possession of the premises, the deposit will be forfeited as damages. I state that the information I have provided is true and correct to the best of my knowledge.
*Applicant's Electronic Signature*:
Date*:
Open the calendar popup.
* Electronic Signature
I declare under penalties of perjury that I have examined this filing, and to the best of my knowledge and belief the information I have provided is correct, complete and legally binding upon me. By typing in my name on this application, I agree to conduct business electronically in accordance with the federal Electronic Signatures in Global and National Commerce Act (E-Sign), 15 U.S.C.A. §§ 7001-7031 (Supp. 2001). I further understand that transactions and/or signatures in records may not be denied legal effect solely because they are conducted, executed or prepared in electronic form, and that if a law requires or permits a record or signature to be in writing, an electronic record or signature satisfies that requirement.

I acknowledge and freely consent that my typed-in name on this application shall constitute a binding electronic signature under the laws of the United States. I recognize that I may be entitled to a paper or other non-electronic form of this document. I understand that prior to my signing this application I can request printed copies should I wish to be supplied with such document copies.

This form is an application for housing. I hereby certify, to the best of my knowledge or belief, that the information in the application is accurate and I agree to comply with the applicable ordinance.

 
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