Century West Properties 1437 Seventh Street, Suite 200 Santa Monica, CA 90401 Phone: (310) 899-9580 / Fax: (310) 899-9470
Property Address:					Apartment:
Application Date:					Move-in Date:
Project:					Rent $
Agent:					Security Deposit $
Phone:					Pet Deposit $
APPLICANT NAME:FIRST	MIDDLE	LAST	BIRTHDATE	SOCIAL SECURITY NO.	DRIVER'S LICENSE #	STATE
SPOUSE NAME:FIRST	MIDDLE	LAST	BIRTHDATE	SOCIAL SECURITY NO.	DRIVER'S LICENSE	STATE
OTHER NAMES EVER USED INCLUDING MAIDEN NAME:
LIST ALL ADDITIONAL ADULTS AND CHILDREN				AGE	RELATIONSHIP TO APPLICANT
CURRENT ADDRESS			PRIOR ADDRESS
STREET			STREET
CITY	STATE	ZIP	CITY		STATE	ZIP
HOW LONG (MO/YR)	FROM	TO	HOW LONG (MO/YR)		FROM	TO
CURRENT PHONE NUMBER			CURRENT PAGER/VOICEMAIL NUMBER
LAST RENT PAID MONTH AMOUNT $			LAST RENT PAID MONTH AMOUNT $
OWNER		PHONE	OWNER		PHONE
MGR		PHONE	MGR		PHONE
REASON FOR LEAVING			REASON FOR LEAVING
EMPLOYMENT	CURRENT EMPLOYMENT		PREVIOUS EMPLOYMENT		PRIOR EMPLOYMENT
EMPLOYED BY
ADDRESS
CITY, STATE, ZIP
EMPLOYER'S PHONE
OCCUPATION/POSITION
TYPE OF BUSINESS
NAME OF SUPERVISOR
DATES OF EMPLOYMENT	MONTHS		MONTHS		MONTHS
MONTHLY SALARY
OTHER INCOME

CREDIT REFERENCES: CREDIT CARDS, CAR LOANS, OTHER LOANS
CREDITOR	ADDRESS/CITY		ACCOUNT NUMBER		BALANCE	PAYMENT
PERSONAL REFERENCES		ADDRESS/CITY		RELATIONSHIP	TELEPHONE	TIME KNOWN
EMERGENCY CONTACT	ADDRESS/CITY		TELEPHONE		RELATIONSHIP	TIME KNOWN
OPERABLE AUTOMOBILES INCLUDING TRUCKS, VANS, MOTORCYLES
ARE YOU THE REGISTERED OWNER?YESNOIF NOT, WHO?
MAKE	YEAR	MODEL	LICENSE PLATE		STATE	COLOR
ADDITIONAL INFORMATION
1) Have you had any credit problems?YesNoIf yes, explain:
2) Have you ever had an unlawful detainer filed against you?YesNo
3) Have you ever been evicted for NON PAYMENT of rent or for any other reason?YesNo
4) Have you ever filed bankruptcy?YesNo
5) Have you ever been convicted for selling, possessing, distribution or manufacturing illegal drugs?YesNo
6) Do you have any pets? YesNo
7) Will you be using any water-filled furniture in your residence?YesNoDescribe:
8) Please explain any "yes" answers:
The facts set forth in this application are true and correct. I authorize verification of the information contained solely for the purpose of establishing my qualifications as a tenant. I release anyone verifying such information or providing information for liability. I understand that incomplete or incorrect information provided in this application may cause a delay in processing and can result in deniaI of tenancy. I further understand any false information or misrepresentation can be a basis for terminating any tenancy that may result if this application is approved. The application will be incorporated into any Rental Agreement or Lease entered into pursuant to this application.I understand the Owner and Management do not tolerate or condone illegal activity in or around the building, including any activity related to narcotics use, possession, sales, manufacturing and distribution.
Applicants Signature:					Date:

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