RENTAL APPLICATION
Southlake Village Apartments
4141 South Seneca
Wichita, Kansas 67217
(316) 522-4855
Email: southlakevillageapartments@cox.net

(Please Print)

Your Phone:______________________________

Applicant's Name: ____________________________________________________________________________________________
(Last) (First) (Middle)

Date of Birth:_______________________ Social Security No._______________________________________ Married?___________

Spouse or Roommates Name:____________________________________________________________________________________
(Last) (First) (Middle)

Date of Birth:_______________________ Social Security No. _________________________________________________________

Children?_____________ Names & Ages:__________________________________________________________________________

Present Address:______________________________________________________________ How Long?_______________________
(Street) (City/State) (Zip)

Present Landlord:___________________________________________ Rent $____________ Phone: __________________________

Applicant Employed By:_______________________________Supervisor _______________ How Long?_______________________

Business Address & Phone:_____________________________________________________ Monthly Income $_________________

Spouse/Roommate Employed By:________________________Supervisor_______________ How Long?_______________________

Business Address & Phone:_____________________________________________________ Monthly Income $_________________

Character References (non-relative):

[1]__________________________________________________ [2]_____________________________________________________

Credit References (loans, credit cards, etc.):

[1]__________________________________________________ [2]_____________________________________________________

Name of Your Bank:____________________________________ Checking:___________________ Savings:____________________

No. of Vehicles:____________ Years & Makes:_____________________________________________________________________

Have you ever broken a lease or been evicted?________________ Any felony convictions? ___________________________________

Next of Kin to be notified in case of emergency:

Full Name____________________________________________ Relationship:____________________________________________

Phone No.____________________________________________ Address: ________________________________________________

 
I hereby agree to sign a lease for __________ months providing for payment of rent monthly, in advance, and to observe all provisions
of the lease and such house rules as may be promulgated to maintain maximum desirability of these apartments and the surroundings.
Number of occupants to live in apartment:___________.
A deposit in the sum of $________________ is made herewith to reserve Apt. No. ____________________________ with the clear
understanding that such amount is to be held by Southlake Village, and is not refundable unless this application is rejected by Southlake
Village, in which case notice of such rejection will be sent by mail to the "present address" above shown and said deposit refunded, less a
$__________ per applicant fee. If not otherwise notified, this application shall be considered accepted and applicant agrees to execute a
written lease and pay the first month's rent on or before _________________________________ or said deposit will be forfeited as
liquidated damages. If applicant terminates this application for any reason, said deposit will be forfeited as liquidated damages.
I also understand that pets are permitted only with special written consent, and additional rental and deposit will be required therefore.
Permission to make complete character and credit investigation is hereby given by applicant to Southlake Village. The undersigned
makes the foregoing representations knowing that Southlake Village will rely on the accuracy thereof in acting on this application.

Signature________________________________ Date_______________

Signature________________________________ Date_______________

____________________________________________________________________________________________________________

Office Use Only:

Type of Apt.______________________________ Apt. No. ________ Carport No.__________ Pets?__________________________

Apt. Rent____________________ Carport ____________________ Apt. Deposit__________________ Paid ___________________

Pet Rent______________________ Total Rent __________________ Pet Deposit___________________ Paid__________________

Credit Report______________________________________________ Other Deposit_________________ Paid__________________

Accept/Reject_________________________________________________________________________________________________
__________________________________________________________________________________________
 
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