Brookview Village

4300 W. Lake Avenue, Glenview, IL 60026-1474

www.BrookviewVillage.com

Phone: 847-724-4603 Fax: 847-724-4614

Date of Application: ____________

Address applying for: ____________ Apt. #: ________________________

Reason for Move: ______________________________________________________________________________

Rent: $___________ Move in Date:____________ Lease Expiration:______________________

How did you hear about Brookview Village? _____________________________________________________________

APPLICANT #1 INFORMATION

Name: _______________________________________

Address: _______________________________________

_______________________________________

Home Phone: ___________________________________

Work Phone: ___________________________________

Soc. Sec. #: ___________________________________

Birth Date: ___________________________________

HOUSING

How long at current address? ________________________

Mortgage Lender or Landlord: _______________________

_______________________________________________

Phone: _________________ Fax: __________________

EMPLOYMENT

Employer: _______________________________________

Address: ________________________________________

________________________________________

Occupation: _____________________________________

How Long? ____________ Salary: $ _______________

Employer’s Phone: ________________________________

Employers Fax: __________________________________

EMERGENCY CONTACT

Name: _________________________________________

Relationship: ____________________________________

Phone: _________________________________________

BANK INFORMATION

Name: _________________________________________

Address: _______________________________________

Account #: ______________________________________

Acct. Type: ______________________________________

APPLICANT #2 INFORMATION

Name: _______________________________________

Address: _______________________________________

_______________________________________

Home Phone: ___________________________________

Work Phone: ___________________________________

Soc. Sec. #: ___________________________________

Birth Date: ___________________________________

HOUSING

How long at current address? ________________________

Mortgage Lender or Landlord:_______________________

_______________________________________________

Phone: _________________ Fax: __________________

EMPLOYMENT

Employer: _______________________________________

Address: ________________________________________

________________________________________

Occupation: _____________________________________

How Long? ____________ Salary: $ _______________

Employer’s Phone: ________________________________

Employers Fax: __________________________________

EMERGENCY CONTACT

Name: _________________________________________

Relationship: ____________________________________

Phone: _________________________________________

BANK INFORMATION

Name: _________________________________________

Address: _______________________________________

Account #: ______________________________________

Acct. Type: ______________________________________

NAME(S), RELATIONSHIP(S), AND DATE(S) OF BIRTH OF ALL OTHERS WHO WILL OCCUPY PREMISES

_________________________________________________________________________________________________

I/We deposit $________ as security deposit and a $25.00 non-refundable application fee. I/We understand that the deposit shall be refunded if the application is rejected by the management company/owner or if the apartment is unavailable. The deposit made shall be used as liquidated damages should I/we cancel, if the information I’ve/we’ve given is false, or if I/we fail to pay any outstanding balance due. The security deposit cannot be used as rent. A full month’s rent must be paid prior to lease inception. A partial month’s rent will be prorated the second month.

I/We hereby authorize Raymond & Associates and their agents to run a credit report and verify all information I/we have provided on this application.

Signature: ______________________________________ Signature:________________________________________

Date: ___________ Date: ___________

Management Approval: _____________________________________________________ Date: ________________

Management Notes: _______________________________________________________________________________