Grayson Management Application

Return by fax or deliver to Mailboxes Etc., 3129 25th Street, Columbus, IN 47203

Fax 812-376-0529 24 Hour Info 812-378-6825 Office 812-376-3500 www.graysonmgt.com

Por favor que se communique con Su Casa Columbus, 375-9370

Date_________ Address of House/Apt. or type needed__________________________________________________

Name with middle initial ________________________________________Birthdate ________________

Social Sec #__________________________

Adult #2 with middle initial _________________________________________Birthdate _______________

Social Sec #________________________________

Daytime phone______________________________________Evening Phone_______________________________

Pager_____________________________________________Emergency Phone____________________________

Cell phone_________________________________ email________________________________________________

When will your new lease begin_____Can you pay the security deposit_____and first month rent________

current lease ends___________________________

Are you on housing assistance______if so, who is your housing authority contact_______________________________

- CHA assistance $_________________________________

Present address__________________________________ Move in month and year____________Rent___________

Present Landlord__________________________________Landlord Phone_________________________________

Why are you leaving________________________________________________________________________

Have you given notice?_________ Do you owe any rent__________________________

Previous Address_____________________________________________

When___________ - _____________Rent___________________

Previous Landlord_________________________________Landlord's Phone__________________________________

Why did you leave__________________________________Do you owe any Rent?____________________________

Employment________________________________________________________Phone_________________________

Start date_______________ Wage_____________Hours per week_______

Pay per week before taxes____________or after taxes_________________

Adult #2 Employment________________________________________________ Phone__________________________

Start date_______________ Wage_____________Hours per week________

Pay per week before taxes____________or after taxes_________________

Other persons:

Name_____________________________________________________________ (Adult _______ Minor_________ )

Name_____________________________________________________________ (Adult_______ Minor_________ )

Name_____________________________________________________________ (Adult _______Minor_________ )

Name_____________________________________________________________ (Adult _______ Minor_________ )

Pets___________________________________ Vehicles_________________________________________________

Car payments per month _________________ Child care expenses per month ________________________________

Support payments paid out monthly_____________ Other payments / judgments monthly__________________________

Have you ever been evicted?_______ Why?____________________________________________________________

Ever sued for non-payment of rent?_______ Why?_________________________________________________________

What will we find when we check with the courthouse and police? ______________________________________________

_________________________________________________________________________________________________

"I grant permission to my employer(s) to release information and to Grayson Mgt. to check credit reports."

Signed__________________________________ Signed______________________________________