Hoosier Uplands

Stalker Apartments

1429 8th St.
Bedford, IN 47421
aalcorn@hoosieruplands.org
(812) 277-8562

Rental Application

If you are done filling out the forms, please click on the "Submit" button at the bottom of the screen.
If you are done filling out the forms, please click on the "Submit" button at the bottom of the screen.
  • 1 Hoosier Uplands - Rental Housing Application
    Please click here to download a printable version of the Hoosier Uplands - Rental Housing Application and fill out manually

    Rental Housing Application

    Name of the apartment complex you are applying for
    Stalker Apartments
    Name of Applicant
    *
    (First, Middle Initial, Last)
    Name of Co-Applicant
    (if applicable - additional applicant must be completed)
    Applicant Email Address
    *
    Applicant Phone Number
    *
    Application Type
    Choose...
    Marital Status
    Choose...
    Driver's License Number
    Driver's License State

    Household Composition

    List all persons that will be occupying the unit
    Full Name
    Relationship to Head of Household
    Date of Birth
    Social Security Number
    Employed?
    Choose...
    Student?
    Choose...

    Rental History

    Last two years

    Present Landlord Name
    Present Landlord Phone
    Landlord Address
    City
    State
    Zip
    Start Date of Occupancy
    End Date of Occupancy
    Are you related to Landlord?
    Choose...
    How are you related to landlord?
    Please indicate how you are related to the landlord if applicable
    Previous Landlord Name
    Previous Landlord Phone
    Previous Landlord Address
    City
    State
    Zip
    Start Date of Occupancy
    End Date of Occupancy
    Are you related to Landlord?
    Choose...
    How are you related to landlord?
    Please indicate how you are related to the landlord if applicable

    General Questions

    Have you or any household member ever been convicted of a felony?
    Choose...
    Have you ever been evicted?
    Choose...
    Eviction Reason
    If you have ever been evicted, please explain
    Have you or any household member been arrested or convicted of a drug related crime?
    Choose...
    Does anyone not listed in the household composition section plan to live with you in the next 12 months?
    Choose...
    If yes, explain
    Will the Household be receiving Section 8 housing assistance?
    Choose...
    If yes, please list agency name, contact person and phone number
    Are there any absent household members who under normal conditions would live with you?
    Choose...
    Does an adult of this household have primary physical custody of every child listed on this application?
    Choose...
    Does your household have or anticipate having any pets other than those used as a service animal?
    Choose...
    Does anyone in your household have special needs?
    Choose...
    If yes, please explain

    Credit References

    Loans
    Credit Cards
    Other

    Character References

    Name
    Relationship
    Phone
    Name
    Relationship
    Phone

    Emergency Contact Number

    In case of emergency, please notify
    Name
    Home Phone
    Work Phone
    Applicant certifies the above information is true and accurate and understands that false or inaccurate information shall be cause for denial of this application or termination of any subsequent rental agreements. I/We are the only person(s) who will reside in the apartment if this application is approved. Apartment owner or agents may verify all information given directly or through reporting agencies. Acceptance of the application is not binding on apartment owner or agent until approved in writing.

    You have applied to live in an apartment that is governed by the Low Income Housing Tax Credit Program. This Program requires us to certify all of your income asset and eligibility information as part of determining your household’s eligibility. Program requirements state we must verify each income and asset source as well as other claims of eligibility. We must determine this prior to granting your eligibility and, if such eligibility is granted, each subsequent year you remain in the unit. The undersigned is the person(s) named above and hereby authorizes Apartment Credit Services to conduct a search of my Criminal Record, Police Record and Motor Vehicle Record information for the purpose of obtaining housing. Additionally, I authorize all companies and law enforcement agencies to release such information, and release them from any liability and responsibility from doing so. A faxed copy of this authorization shall be as valid as the original.

    If applicant cancels after two (2) days, all moneys deposited shall be forfeited to the apartment owner. If approved all moneys deposited with this application will be applied toward security deposit and/or processing fee at owner’s discretion. If an application is denied for ANY reason a 90-day wait period is required before reapplying to this property.
    Head Signature
    *
    Co-head Signature
    Co-Applicant Signature
  • 2 Hoosier Uplands - Authorization to Release Information
  • 3 Hoosier Uplands - Background Check Release
  • 4 Hoosier Uplands - Income Certification Questionaire
If you are done filling out the forms, please click on the "Submit" button at the bottom of the screen.
Equal Housing Opportunity
We encourage and support the nation's affirmative housing program in which there are no barriers to obtaining housing because of race, color, religion, sex, national origin, handicap or familial status.
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