Justus Property Management

Justus Property Management

8 South Main Street
Suite 101, PO Box 396
Whitestown, IN 46075

(317) 834-4756

info@justuspropertymanagement.com

Please click here to download a printable version of the Justus Property Management - Rental Application and fill out manually

Rental Application

Everyone 18 years or older must complete an application
Property Name
Property Type
How did you hear about the property?
Applicant Name
*
(First, Middle Initial, Last)
Email Address
*
Phone Number
*
Size of Apartment
Desired Move-in Date
Marital Status
Household Member Name
*
Relationship to Head of House
*
Social Security Number
Gender
Date of Birth
*

Race
Ethnicity

(This does not include service or companion animals)

if the answer is yes please ask management for the reasonable accommodation form

Check NA if no minors in the household

Please indicate household member name

List amount

Annual Income
*
Source of Income
Unreimbursed Medical expenses
(as qualified above)
Time Frame
(To qualify for Childcare expense you are working, seeking employment, or furthering your education (academic or vocational)
Anticipated Child Care
(available for under 13 including foster children)
Time Frame
(In order to qualify for disability assistance expense, a family member or members [18 or older] must be enabled to work)
Unreimbursed disabled assistance expense
Time Frame
Current Address
*
Current Address (Line 2)
City
*
State
*
Zip
*
Current County
*
How long have you lived here?
*
Landlord's Name
Landlord's Phone
Landlord's Address
Landlord's Address (Line 2)
City
State
Zip
Amount of rent paid?

Reason for Moving
Previous Address
Previous Address (Line 2)
City
State
Zip
Previous County
How long have you lived here?
Landlord's Name
Landlord's Phone
Landlord's Address
Landlord's Address (Line 2)
City
State
Zip
Amount of rent paid?

Reason for Moving
List all states the household members have resided in
Name
Phone Number
Address
Address (Line 2)
City
State
Zip
Number of vehicles?
License #
Make/Model
Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government. HUD and any owner (or any employee of HUD or the owner) may be subject to penalties for unauthorized disclosures or improper use of information collected based on the consent form. Use of the information collected based on this verification form is restricted to the purposes cited above. Any person who knowingly or willingly requests, obtains or discloses any information under false pretenses concerning an applicant or participant may be subject to a misdemeanor and fined not more than $5,000. Any applicant or participant affected by negligent disclosure of information may bring civil action for damages, and seek other relief, as may be appropriate, against the officer or employee of HUD or the owner responsible for the unauthorized disclosure or improper use. Penalty provisions for misusing the Social Security number are contained in the Social Security Act at 208 (a ) (6), (7) and (8). Violation of these provisions are cited as violations of 42 U.S.C.408 (a) (6), (7) and (8).
I ATTEST THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND COMPLETE. I have fully disclosed all relevant information including all household income and assets. I hereby authorize the release and verification of the information contained in this application as requested or a second page as maybe be attached to this signature page to the management of the apartment community to which I have applied. I give my permission for the managing agent to investigate and verify any & all information given in this application.

Applicant Signature
*
DATE
*
Equal Housing Opportunity
This institution is an equal opportunity provider and employer.
Handicap Accessible