Timothy Park: A Residential Duplex Community in Ellensburg, Wa

Timothy Park Rental Application

Each apartment may not be occupied by more than one family or three individuals. In the case of individuals, each must complete a rental application.
A $25.00 nonrefundable application fee (see below for details) is required for processing of each application.
All information must be completed for processing of application.
No pets are permitted

	UNIT REQUEST
	Date Occupancy Desired:	(MM/DD/YY)
	Unit Desired:	single-story two-story
	APPLICANT
	First Name:
	Last Name:
	Birthdate:	(MM/DD/YY)
	Social Security#
	Driver’s License #:
	State Issued
	APPLICANT CURRENT ADDRESS
	Address:
	Address:
	City:
	State:
	Zip:
	Phone Number:
	E-mail:
	Present Landlord Phone Number:

	I will not keep or harbor pets of any kind on the premises without landlord's permission of the landlord.

	I have a physical or mental handicap (explain):

	Name(s) of other persons living with you:
	Full Name:
	Full Name:
	Full Name:
	Full Name:
	CO-SIGNER (if applicable)
	First Name:
	Last Name:
	Birthdate:	(MM/DD/YY)
	Social Security#
	Driver’s License #:
	State Issued
	CO-SIGNER CURRENT ADDRESS
	Address:
	Address:
	City:
	Co-State:
	Zip:
	Phone Number:
	E-mail:
	Present Landlord Phone Number:

	I will not keep or harbor pets of any kind on the premises without landlord's permission of the landlord.

	I have a physical or mental handicap (explain):

	EMPLOYMENT (For Co-Signor if Applicable)
	Employer:
	Contact:
	Address:
	City:
	State:
	Zip:
	Phone:
	Years Employed:	Years Months
	Annual Income:	Year
	Other Income:	Year

	EMERGENCY CONTACT
	First Name:
Last Name:
Relationship:
Address:
City:
State:
Zip:
Phone:

PERSONAL REFERENCES (Please provide two)
First Name:
Last Name:
Relationship:
Address:
City:
State:
Zip:
Phone:

First Name:
Last Name:
Relationship:
Address:
City:
State:
Zip:
Phone:
HISTORY
Yes No	1. Have you ever been evicted?
Yes No	2. Have you ever been convicted of a crime?
Yes No	3. Have you ever had a judgment of any kind entered against you by any court of law?

List last two (2) previous addresses other than your current address:
City:
State:
Zip:

City:
State:
Zip:
VEHICLE
Vehicle Make:
Model:
Year:
License Plate:
State:
APPLICATION TERMS AND AGREEMENT
A $25 non-refundable credit check fee must be received by Landlord before application will be processed. Please mail check to: Timothy Park 1000 East Harvest Loop #300 Ellensburg WA 98926 Completion and submittal of this form does not guarantee you an apartment unless one is available for rent and application is approved by the Landlord. I, the undersigned, certify that all information on this application is true and correct. I understand that this application, should I be accepted as a tenant, will become a part of my Rental Agreement. I also understand that a false or willfully omitted statement on this application will be at the option of the owner/agent, grounds for cancellation of the rental agreement. I hereby give my permission for a complete screening of my application by a screening company as the owner/agent may select. I understand that if my application is denied, I will receive notification in writing.
ADDITIONAL COMMENTS OR CONSIDERATIONS
By pressing "Submit", you agree to all terms and conditions of this application.
To help ensure this entry is being submitted by a human and not an automated computer script, please enter the security code shown below in bold in the provided text field.
	38957
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