AppForm

Resident Application Form

* Indicates required field

Name *

First

Last

Email *

Date of Birth *

Social Security # *

Phone # *

Drivers License # *

D/L State *

Employer Contact Information *

Salary & Income Information *

Rental History (5 years) *

Emergency Contact *

Auto Make/Model Plate# *

Comment/s *

"By submitting my application I hereby authorize Fifth Oak, LLC dba Village East Apartments to obtain a consumer report, and any other information it deems necessary, for the purpose of evaluating my application. I understand that such information may include, but is not limited to, credit history, civil and criminal information, records of arrest, rental history, employment/salary details, vehicle records, licensing records, and/or any other necessary information. I hereby expressly release Fifth Oak, LLC dba Village East Apartments, and any procurer or provider of information, from any liability whatsoever in the use, procurement, or furnishing of such information, and understand that my application information may be provided to various local, state and/or federal government agencies, including without limitation, various law enforcement agencies."

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