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Property Application

Application Fees are $25.00 per person over the age of 18 in the household. (NOTE: An application will not be processed until fees are received.

- I have read and agree to the Application Agreement.

Property Information

Lot Number:

Date you will take occupancy:

Date Submitted:

Applicant type:

Applicant Information

Name:

Date of Birth:

SSN:

Cell Phone:

Email:

Driver's License Number:

Driver's License State:

Driver's License Expiration Date:

Any other name(s) used (including maiden name):

Automobile Information

Make:

Model:

Year:

Color:

License Plate Number:

License Plate State:

Second Vehicle Information

Make:

Model:

Year:

Color:

License Plate Number:

License Plate State:

Residential History

Current Address

Street Address:

Address Line 2:

City:

State:

Residency:

Rent

Landlord Name:

Landlord Phone:

Fax:

Email:

Monthly Rent:

Date In:

Date Out:

Reason for Leaving:

Is your lease expired?

If no, when is your lease expiration date?

Have you given your 30 day notice to vacate?

If yes, what date was your notice given?

If no, is it ok for us to contact your current landlord?

Own

Mortgage Company:

Monthly Mortgage:

Date In:

Date Out:

Reason for Leaving:

Previous Address

Street Address:

Address Line 2:

City:

State:

Residency:

Rent

Landlord Name:

Landlord Phone:

Fax:

Email:

Monthly Rent:

Date In:

Date Out:

Reason for Leaving:

Own

Mortgage Company:

Monthly Mortgage:

Date In:

Date Out:

Reason for Leaving:

Applicant Questions

Have you ever been asked to move out of a residence?
If Yes, Please Explain:

Have you ever been party to an eviction?
If Yes, Please Explain:

Are you a registered sex offender?
If Yes, Please Explain:

Have you or any member of your household been convicted or pleaded no contest to a felony?
If Yes:
Name:
Date of Conviction:
Description of Crime:

Have you ever filed bankruptcy?
If Yes, Please Explain:

Have you ever had any collections?
If Yes, Please Explain:

Co-Applicant Information

Relation to applicant:

Name:

Date of Birth:

SSN:

Cell Phone:

Email:

Driver's License Number:

Driver's License State:

Driver's License Expiration Date:

Any other name(s) used (including maiden name):

Automobile Information

Make:

Model:

Year:

Color:

License Plate Number:

License Plate State:

Second Vehicle Information

Make:

Model:

Year:

Color:

License Plate Number:

License Plate State:

Residential History - Co-Applicant

Current Address

Street Address:

Address Line 2:

City:

State:

Residency:

Rent

Landlord Name:

Landlord Phone:

Fax:

Monthly Rent:

Date In:

Date Out:

Reason for Leaving:

Is your lease expired?

If no, when is your lease expiration date?

Have you given your 30 day notice to vacate?

If yes, what date was your notice given?

If no, is it ok for us to contact your current landlord?

Own

Mortgage Company:

Monthly Mortgage:

Date In:

Date Out:

Reason for Leaving:

Previous Address

Street Address:

Address Line 2:

City:

State:

Residency:

Rent

Landlord Name:

Landlord Phone:

Fax:

Email:

Monthly Rent:

Date In:

Date Out:

Reason for Leaving:

Own

Mortgage Company:

Monthly Mortgage:

Date In:

Date Out:

Reason for Leaving:

Emergency Contact Information

Emergency Contact

Name:

Phone:

Email:

Address:

City:

State:

Nearest Relative

Name:

Phone:

Email:

Address:

Address Line 2:

City:

State:

Additional Comments or Notes

Application Completion

DISCLOSURE AND AUTHORIZATION

The undersigned declares that the information on this rental application is true and correct, and understands that false statements may result in rejection of this and any future applications for housing we manage. The undersigned does further understand that all persons or firms associated with Liberty Tiny Village may freely give any requested information concerning me.

I also hereby authorize Liberty Tiny Village to verify my past and present employment earnings records, bank statements, previous residences and/or any information given for the purposes of renting and/or leasing through Liberty Tiny Village including but not limited to a credit check. I further understand and agree that Liberty Tiny Village will rely upon this rental application as an inducement for entering into a rental agreement or lease and I warrant that the facts contained in this application are true. If any facts prove to be untrue, Liberty Tiny Village may terminate my tenancy immediately and collect from me any damages incurred including reasonable attorney fees resulting there from. Liberty Tiny Village welcomes all applicants and supports fair housing. We do not refuse to lease or rent any housing accommodations or property nor in any other way discriminate against a person because of sex, marital status, race, creed, religion, age, familial status, physical or mental handicap, color or national origin.

Investigational Background Search Disclosure

Liberty Tiny Village conducts applicant screening on persons applying to live in our managed properties, such screenings may include criminal background investigations. Prior to acceptance of an applicant, we may use an independent consumer reporting agency to search public records which may contain criminal background information regarding the applicant. Liberty Tiny Village will determine if the criminal background information pertains to the applicant and if the report indicates that one or more such felony and or misdemeanor records were found. We will then compare the records to our established acceptance policies to determine whether or not the applicant may be accepted. If your application is declined based on the discovery of public records that indicate an unacceptable criminal background, you will be given the name, address, and telephone number of the consumer reporting agency that provided the criminal background report. An applicant who is declined based on a criminal background may obtain a free copy of the report and may initiate a reinvestigation to have any erroneous information contained in the report corrected. The consumer reporting agency will advise you of the procedures that you should follow in order to do so.

Under California Civil Code section 1786.22, you are entitled to find out from an ICRA what is in the ICRA’s file on you with proper identification, as follows:

In person, by visual inspection of your file during normal business hours and on reasonable notice. You also may request a copy of the information in person. The ICRA may not charge you more than the actual copying costs for providing you with a copy of your file.
A summary of all information contained in the ICRA’s file on you that is required to be provided by the California Civil code will be provided to you via telephone, if you have made a written request, with proper identification, for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.
By requesting a copy be sent to a specified addressee by certified mail. ICRA’s complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the ICRAs.

“Proper identification” included documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity.

The ICRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection.

You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person’s presence.

I live in California and would like a copy of any criminal or credit report acquired:

Valid Photo Identification must be presented prior to final approval of this application.

I, the undersigned Applicant, agree to the above terms and do hereby swear (or affirm) that the information supplied herein is true and complete, to the best of my knowledge and belief. By clicking "Apply Now" you agree to the terms stated above. Please enter your full name to signify your digital signature, thereby confirming that you have read and agree with all the above statements and have provided complete and accurate information. Applicant authorizes verification of references given and declares that the statements made in this application are true and correct and agrees that the landlord may terminate the contract entered into in reliance on any misstatement made in this application.

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Signed by Aleesha Agee
Signed On: February 21, 2025

Timestamp

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February 18, 2025 1:12 pm CST

Property Application Uploaded by Aleesha Agee - eleshascrv@gmail.com IP 47.158.149.252