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Intake Form
for Extended-Stay Vacancies
Pre-application for Rental Unit
Date:
Name:
Phone:
Email:
Total number of occupants:
Names of ALL occupants:
Combined Income of all occupants:
Experian FICO Score of occupant 1 (If not known, write "00"):
Experian FICO Score of occupant 2; If only 1 Occupant, write "1":
Where is each occupant Employeed:
Will you require a co-signer?
Any military service?
Have you ever been evicted or declared bankruptcy? (If yes, please explain)
Any pets?
Do you smoke?
Anticipated Date of Check-in?
Antipated Date of Check-out
Preferred unit and its listed rent:
Do you have any of the following: fever or chills, cough, shortness of breath or difficulty breathing, body aches, headache, new loss of taste or smell, sore throat?
Do you have, had, or come into close contact (within 6 feet) with someone who has a laboratory confirmed COVID – 19 diagnosis in the past 14 days?
Thank you! Your submission has been received!
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