Rockwood Gardens Apartments
51 Rockwood Circle - Rental Office,
Apt. 20A  Middletown, NY 10941

Rockwood Gardens Apartments   51 Rockwood Circle - Rental Office, Apt. 20A    Middletown, NY 10941

This application will not be considered unless filled out completely.
All Security deposits are non-refundable unless Rockwood Gardens, at it's sole description, rejects this application.

Print out or download to your desktop "Printable Rental Application"

Fill it out completely
Sign it
Provide a copy of a Drivers License
Provide a copy of a Social Security Card
Send it to us
Each applicant 18 years or older must fill out their own application.

What floor level? ________________

When needed? ______________________

# of Bedrooms ____ 1 ____ 2

Pet? ____ Type of Pet _______________

Applicant #1 (full name) ____________________________________________________
Social Security # ______________________ Date of Birth __________________
Martial Status _____________________________ 
Current Address ___________________________ City ________________________
State ________________ Zip _________________ Telephone # __________________
Current Landlord _____________________________ Telephone # __________________
How Long at Current Address? __________________ Rent Amount $ _____________/mo
Reason for Moving? ________________________________________________________
Previous Address _____________________________ City ________________________
State ________________ Zip _________________ How Long? __________________
Previous Landlord ____________________________ Telephone # __________________
Employer ___________________________________ Personnel Telephone # __________
Employer's Address _____________________________________________ Zip ________
Position Held ________________________________ How Long? __________________
Annual Income from Employment $ _______________ Additional Income $ ____________
Describe Source of Additional Income ___________________________________________
Phone # if Applicable __________________________ 

Credit References

Name/Address of Bank ____________________________________________ Zip __________
Credit Cards Held ___________________________________________________________
Make and Year of Car _________________________ License Plate # _________________
Driver's License # ____________________________ Registration # __________________
Copy of License _______________________________ Copy of Social Security Card _____________
In Case of Emergency, Contact: 
Name ________________________________________ Relationship ________ Tel# ________
Address _____________________________________________________________________
City _________________________________________ State _______________ Zip _______
Emergency Contact #2: 
Name ___________________________________________________ Tel # _______________
Please List All Other Persons Who Will Reside in this Apartment:
Name ________________________________ Relationship ______________ D/O/B _________
Name ________________________________ Relationship ______________ D/O/B _________
Name ________________________________ Relationship ______________ D/O/B _________

Note: Having persons living in the apartment other than those listed would be a breach of lease and may result in eviction.

This does not represent an offer to lease an apartment, but is an application only. Nothing will be binding on either party unless, and until a Lease is fully executed by both the Landlord and Tenants (s).

I hereby authorize the persons listed above to release to the Landlord any information contained in this application, in order to process this application.

I hereby warrant that all my representations set forth above are true. I further represent that I am not renting another residence under any other name, nor have I ever been dispossessed from any apartment, nor am I now being dispossessed.

* No Pets Allowed *
Other than cats within certain restrictions. See Landlord's agent for details.

Signature _____________________________________________________________     Date _________________________

Received by __________________________________________________________     Date _________________________

Rockwood Gardens Associates
51 Rockwood Circle Apt. 20A Rental Office
Middletown, NY 10941


Rental Application Terms


This application is subject to the owners and/or agents review, and may be denied by them without designating the cause except as hereinafter provided. If and when a lease is made this application will be made a part of the lease. The truth of information contained herein is essential and if the owner / or its agents deems any answer or statement herein to be false or misleading, it shall be considered that any lease granted by virtue of this application may be cancelled immediately at our option. I hereby authorize Rockwood Gardens Associates and/or Snow Asset Management, Inc. as Management Agent to use any consumer reporting agency, credit bureau, or any other investigative agencies employed by such, to investigate the references herein and other data obtained from me or from any other person pertaining to my employment history, credit, prior tenancies, and character to obtain a consumer report and such other credit information, and to disclose such information to the subscriber in support of this application and in the event that a lease is made any time during the lease. I have been advised that I have the right under Section 606B of the Fair Credit Reporting Act, to make a written request, within a reasonable time, for a copy of my credit report should my application for a Lease be denied on the basis of information contained in the credit report. I further give permission to all references listed to respond confidentially to requests for information regarding my employment history, prior tenancies, and / or character. It is understood and agreed that in the event of a lease it will be used strictly as a residence and to be occupied by no more than_________ persons.

______________________________ ________________
Signature of Applicant                         Date
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