APPLICATION FOR SENIOR CITIZEN HOUSING

Landlord may refuse to rent to Applicant if any of the information provided herein is found to be untrue, and may terminate Applicant’s tenancy if information provided herein is found to be untrue after renting to Applicant.

I authorize the person to whom this application is made and any credit bureau or other investigative agency employed by such person to investigate any references herein listed or statements or other data obtained from me or from any other source pertaining to my credit or financial responsibility. I also authorize the person to whom this application is made (including his or her agents) to obtain a copy of my credit report to assist in evaluation my application and thereafter, to obtain and use in attempting to collect unpaid rent, late fees, or other charges from me.

I the undersigned understand that this is not a contract and does not bind either party. The above information is full, true, and complete to the best of my knowledge. I have no objections to inquiries being made for the purpose of verifying the statements made herein. I also understand it is my responsibility to keep Warren Senior Housing, informed of any changes in address, phone alphabetical listing, etc. that take place after this application date.

Should you disagree with the decision of the housing director, you have the right to appeal in writing to the housing commission.

I certify that the information I have provided in response to the questions contained in this application are true. I further certify that I have read the conditions contained on the application form, that I understand them, and that I voluntarily submit this application.