Chouteau Heights Application for Occupancy
CHOUTEAU HEIGHTS APTS/BLUE SPRINGS REALTY APPLICATION FOR OCCUPANCY
Application must be completely filled out. Fee is $40/person, cash or PayPal only.
Phone: 816.453.2414 E-mail: chouteauheights@gmail.com PayPal: paypal.me/reginakempf
Email address *
Phone Number *
Your answer
Apartment Type *
Today's Date *
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Desired Date of Occupancy *
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Do you have pets? *
What kind? Weight? *
Your answer
Name: First, Middle, Maiden, Last *
Your answer
SSN *
Your answer
Date of Birth *
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YYYY
Check One: *
Number of people who will occupy? Adults & Children (each adult must fill out an application) *
Your answer
Child/Children's Name, Date of Birth *
Your answer
In case of an emergency, notify? (name & number) *
Your answer
PART I - RESIDENCE HISTORY
Present Address: Address, City, State, Zip *
Your answer
Rent Amount *
Your answer
Date's There (move in date - lease end) *
Your answer
Present Apartment Complex/Landlord *
Your answer
Landlord Phone Number *
Your answer
Landlord Email *
Your answer
Previous Address: Address, City, State, Zip *
Your answer
Rent Amount *
Your answer
Date's There *
Your answer
Previous Apartment Complex/Landlord *
Your answer
Previous Landlord Phone Number *
Your answer
Previous Landlord Email *
Your answer
PART II - EMPLOYMENT
Employer Name and Address *
Your answer
Employer Phone Number and Email *
Your answer
Position or Department *
Your answer
Dates of Employment *
Your answer
Monthly Income Amount *
Your answer
Other Income/SSI/Disability? *
Your answer
Have you ever been convicted, plead guilty to or been in jail for a crime? *
Do you have any pending criminal charges? *
Number of Cars? Make/Model, Color, Year, Plate Number? *
Your answer
Driver's License Number and State *
Your answer
DISCLOSURE AND AUTHORIZATION (IMPORTANT - PLEASE READ CAREFULLY BEFORE SIGNING ACKNOWLEDGMENT) DISCLOSURE REGARDING BACKGROUND INVESTIGATION
CHOUTEAU HEIGHTS APARTMENTS/BLUE SPRINGS REALTY (Company) may obtain information about you from a consumer reporting agency for tenant screening purposes. Thus, you may be the subject of a “consumer report” and/or an “investigative consumer report” which may include information about your character, general reputation, personal characteristics, and/or mode of living, and which can involve personal interviews with sources such as your neighbors, friends or associates. These references, credit history, professional licenses and credentials. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to applicants for residency is an investigation into your education and/or employment history conducted by Datasource, Inc, 1200 NW South Outer Rd, Blue Springs, MO 64015, Phone: 816-228-5255, Fax: 816-224-9699, or another outside organization. This Disclosure and Authorization allows the Company to obtain from any outside organization all manner of consumer reports and investigative consumer reports now and, if approved for residency, throughout the course of your tenancy to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report.

ACKNOWLEDGMENT AND AUTHORIZATION:

I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION (above) and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT (attached) and certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” at any time after receipt of this authorization and, if I am approved for residency throughout my tenancy. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Datasource, Inc, 1200 NW South Outer Rd, Blue Springs, MO 64015, Phone: 816-228-5255, Fax: 816-224-9699, another outside organization acting on behalf of the Company, and/or the Company itself. I agree that a facsimile (fax), electronic or photographic copy of this Authorization shall be as valid as the original. I understand that signing my name in the Name section below, and my Social Security Number in the SSN section above, that by doing so:
*I am authorizing Datasource, Inc to conduct the background check(s) described above.
*I am consenting to use of this completed form and have read and understand the above disclosure.
*I acknowledge I may request a hard copy of this Disclosure and Authorization form after agreeing to the background check.
A non-refundable processing charge of $40 cash per person will be retained by the Landlord.

By typing your name below, you acknowledge that it constitutes as your electronic signature. *
Your answer
CHOUTEAU HEIGHTS APARTMENTS APPLICATION INFORMATION AND PROCESS
All applicants are thoroughly screened.

This includes:
*Credit
*Criminal
*Past rental history
*Must make 2.5 times the rent

Applicants must have rental history that DOES NOT include family members. I DO NOT accept any evictions.

We require a copy of:
*Your most recent paycheck stub
*Your driver's license
*Social security card
*Vehicle insurance card
*Your most recent bank statement
*Paperwork from your veterinarian’s office stating your pets breed, weight, age, current on shots.

We will consider an application incomplete if I do not receive all the above.
Applicant understands that required copies of documents listed above must be emailed or dropped by the office and the application fee must be paid via cash or PayPal before the application will be processed. *
A copy of your responses will be emailed to the address you provided.
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