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Welcome to The Pines

We Have A Space For Your Place!
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THE PINES
100 White Pine Boulevard
New Albany, IN 47150
812 949-3064

"The Pines, New Albanys newest manufactured home community"

RENTAL APPLICATION

Please Note: This will NOT be processed until a $35.00 non-refundable application fee and a copy of your drivers license is received at our office.

Printable version

PERSONAL INFORMATION

Do not press the ''Enter'' key until you are ready to submit this form.

Applicant's Full Name:	Social Security No.:
Date of Birth (mm/dd/yyyy):	Marital Status:

Others to Reside in Apartment:

Name: Soc. Sec. No.: Relationship: Date of Birth (mm/dd/yyyy):	Name: Soc. Sec. No.: Relationship: Date of Birth (mm/dd/yyyy):
Name: Soc. Sec. No.: Relationship: Date of Birth (mm/dd/yyyy):	Name: Soc. Sec. No.: Relationship: Date of Birth (mm/dd/yyyy):
Name: Soc. Sec. No.: Relationship: Date of Birth (mm/dd/yyyy):	Name: Soc. Sec. No.: Relationship: Date of Birth (mm/dd/yyyy):

Have you ever been evicted?
Have you ever declared bankruptcy?

RESIDENCE HISTORY

Present Address

Street Address:

Apt No.:

City:	State:	Zip:	Phone:
Rent or Own:	Dates (mm/dd/yyyy):	To (mm/dd/yyyy):	Monthly Payment:

Landlord/Lender:

Street Address:

City:

State:

Phone:

Previous Address

Street Address:

Apt No.:

City:	State:	Zip:	Phone:
Rent or Own:	Dates (mm/dd/yyyy):	To (mm/dd/yyyy):	Monthly Payment:

Landlord/Lender:

Street Address:

City:

State:

Phone:

EMPLOYMENT INFORMATION

Current Employer

Name:

Street Address:

City:	State:	Zip:	Phone:
Employment Dates (mm/dd/yyyy):	To (mm/dd/yyyy):	Position:	Supervisor:
		Salary:	Per:

Previous Employer

Name:

Street Address:

City:	State:	Zip:	Phone:
Employment Dates (mm/dd/yyyy):	To (mm/dd/yyyy):	Position:	Supervisor:
		Salary:	Per:

Spouse's Employer

Name:

Street Address:

City:	State:	Zip:	Phone:
Employment Dates (mm/dd/yyyy):	To (mm/dd/yyyy):	Position:	Supervisor:
		Salary:	Per:

BANKING AND CREDIT REFERENCES

Bank:	Branch:
Checking Account No.:	Savings Account No.:

Credit Reference:

Account Number:

Entire Address:

Credit Reference:

Account Number:

Entire Address:

Credit Reference:

Account Number:

Entire Address:

Credit Reference:

Account Number:

Entire Address:

Credit Reference:

Account Number:

Entire Address:

Credit Reference:

Account Number:

Entire Address:

Other Reference:

Entire Address:

OTHER INFORMATION

Automobiles

Number of Automobiles (Including Company Cars):

Driver's License No.:

Make:	Year:	Color:	Tag No.:	State:
Make:	Year:	Color:	Tag No.:	State:
Make:	Year:	Color:	Tag No.:	State:

Relatives/Emergency Contact (Not Residing With You)

(1) Name:

Relationship:

Phone:

Street Address:

City:

State:

Zip:

(2) Name:

Relationship:

Phone:

Street Address:

City:

State:

Zip:

By submitting this form, I hereby make application for an rental lot at The Pines and certify that all the information I have provided is correct and complete. I authorize the management of The Pines to contact any references and verify the information listed on this application. This includes obtaining a consumer credit and/or public records report. I also realize that the electronic transmission of this information in this form is not secure, and thus it is technically possible (though not likely) for others to ''eavesdrop'' on my information. I will not hold The Pines, their webmasters, their webhosts, and/or any other associated parties responsible if others do ''eavesdrop'' on my information.

http://www.pinescommunity.com/

Introducing The Pines, New Albany's newest Manufactured home community. We offer you beautiful, well maintained lots for lease in a quiet, peaceful residential area. Our location is excellent with easy access to 2 major interstates, shopping, schools hospitals and downtown Louisville. So stop by & visit us today - we know you'll want to place your home in our community.

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