Lease App

Please Print This Form to Fill Out & Mail In With $40.00 Application. $50 for married.

Fee This is A Non-Refundable Processing Fee.

GENESIS PROPERTIES INC. 11511 Allecingie Parkway, Richmond, VA 23235 804/379-8267 Fax 379-4304

APPLICATION FOR LEASE

The Applicant(s) named below hereby apply on (Date)_______________ for lease of the following described property located in the City or County of: ____________________.

Occupancy to begin__________________________ Address Applying for:___________________________________.

NAME OF APPLICANT:_____________________________________Birth Date:___________SSN:__________________

TELEPHONE NUMBER (H)__________________________________ (W) ______________________________________

PRESENT ADDRESS: ________________________________________________________HOW LONG______________
(city, state, zip)
LANDLORD: ________________________________ PHONE #_________________________ RENT $______________

REASON FOR LEAVING ___________________________________________________________________________________________

PREVIOUS ADDRESS_______________________________________________________HOW LONG______________
(city, state, zip)
LANDLORD:________________________________ PHONE #__________________________ RENT $______________

REASON FOR LEAVING ____________________________________________________________________________________________

HAVE EVICTION PROCEEDINGS EVER BEEN FILED AGAINST YOU? YES____ NO____

Explain:_________________________________________________________________________________________

LIST THREE FAMILY OR LOCAL REFERENCES:
Name Address Phone Relationship

________________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

APPLICANT'S EMPLOYER:________________________________ PHONE #________________ HOW LONG: _________

POSITION____________________________ SALARY ____________________FULL OR PART TIME:________________

HOURS PER WEEK):____________ ADDITIONAL INCOME EXPLAIN):__________________________________________

PREVIOUS EMPLOYMENT: ______________________________ PHONE #_________________ HOW LONG: _________

POSITION____________________________ SALARY ___________________ FULL OR PART TIME:________________

OTHER OCCUPANTS: Name______________________________________Age:__________Relationship:__________________________

Name______________________________________Age:__________ Relationship:_________________________

Name______________________________________Age:__________ Relationship:_________________________

Name______________________________________Age:__________ Relationship:_________________________

APPLICANT: DO YOU HAVE PETS? YES____ NO____ WHAT KIND?________________________WEIGHT___________

********MINIMUM ADDITIONAL SECURITY DEPOSIT FOR PETS IS $100.00 *********

A THIRTY DOLLAR PROCESSING FEE MUST ACCOMPANY THIS APPLICATION!

******************THIS IS A NON-REFUNDABLE PROCESSING FEE.****************

LIST AUTOMOBILES OF ALL OCCUPANTS
Make & Model                                     Year & Color                          State, License Number

________________________________________________________________________________________________

_______________________________________________________________________________________________

NAME OF CO-APPLICANT:_________________________________________ Birth Date:_________SSN:____________

TELEPHONE NUMBER (H)__________________________________(W)_______________________________________

PRESENT ADDRESS:____________________________________________________________HOW LONG__________
(city, state, zip)
LANDLORD:______________________________________ PHONE #____________________ RENT $______________

REASON FOR LEAVING ____________________________________________________________________________________________

PREVIOUS ADDRESS____________________________________________________________HOW LONG_________
(city, state, zip)
LANDLORD:_______________________________________ PHONE #____________________RENT $______________

REASON FOR LEAVING ____________________________________________________________________________________________

HAVE EVICTION PROCEEDINGS EVER BEEN FILED AGAINST YOU? YES____ NO____

Explain:__________________________________________________________________________________________

APPLICANT'S EMPLOYER: ____________________________ PHONE #___________________ HOW LONG: _________

POSITION__________________________ SALARY ___________________FULL OR PART TIME:___________________

(HOURS PER WEEK):________________ ADDITIONAL INCOME EXPLAIN):_____________________________________

PREVIOUS EMPLOYMENT: _____________________________PHONE #___________________ HOW LONG: _________

POSITION__________________________ SALARY __________________ FULL OR PART TIME:___________________

LIST THREE FAMILY OR LOCAL REFERENCES:
Name                   Address                          Phone                Relationship

________________________________________________________________________________________________

_______________________________________________________________________________________________

________________________________________________________________________________________________
Applicant(s) authorize landlord or Agent to verify the foregoing information and to make credit and reference inquiries deemed necessary. Applicant(s) also authorize the release of information contained on this Application or sought by such inquiries. In making this Application, it is understood that an investigative consumer report and criminal report may be prepared whereby information is obtained through personal interviews. This inquiry includes information as to the character, general reputation, and mode of living of Applicant(s).

The parties confirm that in connection with the transaction contemplated by this lease, GENESIS PROPERTIES INC. and its Agents have and are acting as, on behalf of the Landlord or as Landlord's Agent.
I/We certify that the information provided herein is true and accurate to the best of my/our knowledge and fully understand and agree that any information found to be untrue could result in the refusal by Landlord/Realtor to lease to me/us and the forfeiture of any Security Deposit paid with this application. It is further understood that should a property be leased to me based on information discovered to be untrue, Landlord/Realtor maintains the right to terminate my/our lease and to hold Lessee responsible for any damage to the property and to avail himself of all rights and remedies too which he may be entitled either at law or in equity, and to recover reasonable attorney’s fees and costs as allowed by law.

Signature of Applicant: ________________________________________Date:_______________________

Signature of Co-Applicant:______________________________________Date:_______________________

GENESIS PROPERTIES INC.                                                                                            804/379-8267
11511 Alleingie Parkway, Richmond, VA 23235                               Fax 379-4304

REQUEST FOR VERIFICATION OF EMPLOYMENT

Part 1 - Request
    1. (Name and address of Employer)

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

    2. (Name and address of APPLICANT)

    __________________________________________________________________

    __________________________________________________________________

    __________________________________________________________________

I have qpplied for a rental/sale property and stated that I am now or was formerly employed by you. My signature below permits verification of this information. Thank you for yourassistance.

                            ______________________________
                                          Signature of Applicant

APPLICANT(S), PLEASE DO NOT WRITE BELOW THIS LINE.

Part 2 - Verification of Present Employment
    1. Applicant's Date of Employment ______________________________________________

    2. Present Position __________________________________________________________

    3. Probability of Continued Employment __________________________________________

    4. Current Base Pay $_______________________ per _________________________
Part 3 - Verification of Previous Employment

    1. Date of Employment _______________________________________________________

    2. Salary/wage at termination $ ________________ per __________________________

    3. Reason for leaving ________________________________________________________

    4. Position Held ____________________________________________________________

    Signature Of Employer _______________________________________________________

    Title ________________________________________ Date _________________________

The confidentiality of the information you have furnished will be preserved except where disclosure of this information is required by applicable law. This form is to be transmitted directly to Genesis Properties Inc., and is not to be transmitted through the applicant.

GENESIS PROPERTIES, INC.

11511 ALLECINGIE PARKWAY

RICHMOND, VA 23235

LANDLORD REFERENCE

Name of Applicant:______________________________________________________________
Lived at:______________________________________________________________________
Signature of Applicant(s) authorizing the release of the following information:
_____________________________________________________________________________
When did tenant rent from you (move-in and move-out dates)?___________________________
What was the monthly rent: $____________________________________

___ ___ Did the tenant pay rent on time? Yes No If no, number of times late:____

___ ___ Any NSF checks within the last twelve (12) months? If yes, how many and their disposition?_________________________________________

___ ___ Any “Pay or Quits” within the last twelve (12) months? If yes, how many and

their disposition?_________________________________________

___ ___ Any “UDs” within the last twelve (12) months? If yes, how many and

their disposition?_________________________________________

___ ___ Any “21 Day Notices” within the last twelve (12) months? If yes, reason and

their disposition?_________________________________________

___ ___ Is tenant’s account satisfactory? If no, what is the balance due?_________

___ ___ Did the tenant have pets? If yes, were there any problems?

_______________________________________________

___ ___ Did the tenant make any unreasonable demands or complaints? If yes,

please explain:______________________________________

_______________________________________________________

___ ___ Did the tenant give the proper amount of notice before leaving? If no,

please elaborate________________________________________

___ ___ Do you know why tenant is leaving? If yes, please state

reason:_________________________________________________

___ ___ Was tenant considerate of neighbors, that is no loud parties and fair, careful

use of common areas?

If no, please elaorate___________________________________

______________________________________________________

___ ___ Would you rent to this tenant again?

___ ___ Did tenant have a co-signer or guarantor?

If past tenant:

___ ___ Did tenant leave the place in good condition?

___ ___ Did you need to use the security deposit to cover damages, etc? If yes,

elaborate:_______________________________________________

Any particular problems you would like to mention?____________________________________
______________________________________________________________________________
Other Comments:_______________________________________________________________
______________________________________________________________________________

Your Name__________________________Title________________________Date___________

CO-SIGNER FORM

You are being asked to guaranty the payments of a Tenant. Please be aware if you do agree to this, you are responsible for all Tenant charges. If the Tenant does not pay any appropriate charges, you will be billed. This could include: current rent, past due rent, collection costs, non-sufficient funds charges, court costs, late fees, advertising costs, or cleaning and repairs.

Our Company can collect these debts from you without first trying to collect directly from the Tenant. Our company can use the same collection methods with you that can be used with the Tenant. If the Tenant is ever in default of any Tenant obligation, you are responsible.

The Co-signer agrees to unconditionally, absolutely and continually guaranty the performance by Tenant of all obligations under the Rental Agreement, including but not limited to timely payment of the rent and all other financial obligations due Owner. The liability of a co-signer is direct and unconditional and my be enforced without requiring Landlord first to exercise, enforce or exhaust any right or remedy against Tenant. The Co-signer waives presentment, demand, protest and notice of acceptance, notice of demand, notice of protest, notice of dishonor, notice of default, notice of nonpayment, and all other notices to which co-signer might otherwise be entitled.

The co-signer recognizes that the Landlord has agreed to rent to Tenant only because of this guaranty and that the continued validity of this guaranty is a material term of the Rental Agreement. In the event the co-signer terminates the guaranty, or this guaranty is no longer enforceable for any reason, the Landlord may terminate the Rental Agreement of the Tenant.

The Co-signer agrees that any suit or action brought on this Rental agreement may be brought in any state or federal court sitting in the county in which in the property is located. Co-signer agrees to pay all costs and attornery's fees incurred by Landlord in enforcing the Rental Agreement.

Please be sure you want to accept this responsibility and that you are able to assume the financial obligation should that become necessary.

Co-Signer Name:___________________Signature:________________________

Address:_________________________________________

Home Phone:___________________ Work Phone:____________________

Employer:_________________ Salary:___________________ Supervisor:_____________

Social Security #: ______________ Birth Date:_________________