PMR NYC Inc. Rental Application Please fill out the information below. First Name* Last Name Cell Number* Date of Birth* SSN* Drivers License #* State* Expires* Current Address* Current Landlords Name* Landlords Phone #* How Long At This Address* Reason For Leaving* Present Employer* Position* Monthly Income* Phone #* How Long At Job* Other Income* Employers Address* Number & Types of Pets* Have You Ever BeenYesNo Name of Bank Institution* Branch* Type of Account* Personal References Name* Years Known* Relationship* Phone #* Name* Years Known* Relationship* Phone #* Total Number Of Adults* Total Number Of Children Living With You Under 18* Name & Relations Of All Other Applicants* Good Faith Deposit Address of Prospective Apartmen* Good Faith Deposit of* You have submitted a Good Faith Deposit in the amount stated above. In consideration of the Good Faith Deposit, Premier Metro Realty will immediately submit your application to the owner or his agent for approval. The approval of your application is subject to the owner’s or manager’s acceptance. Please Note: the Good Faith Deposit is ONLY refundable if the applicant is not accepted by the owner or Management Company. The Good Faith Deposit is NOT refundable if the applicant withdraws his/her application or fails to submit the required documentation. Applicant confirms that all required paperwork and lease signing must take place within 72 hrs after a deposit has been submitted. If you are eligible for a refund of the Good Faith Deposit (owner or his agent rejected your application) you must arrange to receive it from Premier Metro Realty Corp. within fifteen (15) days from the date you sign the Deposit Receipt or the Good Faith Deposit will be forfeited. By elecronically signing below, you agree to the above terms. I (we) the undersigned, hereby state(s) that the above information given to PMR Dekalb Inc. is true. I (we) authorize PMR Dekalb Inc. to verify my (our) past and present employment earnings records, and or any other documents that are needed to process this application. I further authorize PMR Dekalb Inc. to order a consumer credit report and verify other information including past and present mortgage and landlord / tenant information. It is understood that a copy of this form will also serve as an authorization. In addition, I understand that all application and rental credit check fees are non- refundable. Electronic Signature* Email Address* Date* Submit