Pine Shores Rental Application PDF (download & print version)
**If completing the printed version, please drop it by our main office located at:

6113 Giant City Rd.
Carbondale, IL 62902
(618) 457-5700

Move-in Information PDF


Rental Application Instructions:

1) Enter N/A in fields that are not applicable to your current or previous living and/or employment situation.
2) Each applicant will need to fill out a separate application (even if married).
3) Information provided should be to the best of your knowledge.
4) Information is required in all fields marked with an asterisk (*).
5) A $20.00 non-refundable application processing fee is required for investigation.


PERSONAL INFORMATION

*First and Last Name: Maiden Name (if applicable):

*Date of Birth: *Your Email:

*Phone: *Work Phone:

SSN:

AUTO INFORMATION

Drivers License#: State Issued: License Plate#:

Year: Make: Model: Color:

CURRENT ADDRESS

Street Address: City: State: Zip:

County: Amount Paid:

Landlord Name: Landlord Address:

City: State: Zip:

Landlord Phone:

Is Rent Current: YesNo

Have you given notice: YesNo

Reason for Leaving:

Have you ever been asked to leave: YesNo

If yes, please explain:

PREVIOUS ADDRESS

Landlord Name: Previous Address:

City: State: Zip:

County: Landlord Phone:

Was rent current: YesNo

Did you give notice: YesNo

Were you asked to leave: YesNo

If yes, please explain:

OCCUPANTS

#1: First and Last Name: Relationship:

#2: First and Last Name: Relationship:

#3: First and Last Name: Relationship:

CURRENT EMPLOYMENT

Employer Name: Employer Address:

City: State: Zip:

Employer Phone:

Employed Since:

Monthly Income: Other Sources of Income: YesNo

If yes, please explain:

(Complete the following if holding more than one job)

Employer Name: Employer Address:

City: State: Zip:

Employer Phone:

Employed Since:

Monthly Income: Other Sources of Income: YesNo

If yes, please explain:

REFERENCE & CONTACT INFORMATION

Relative #1
First and Last Name: Relation:

Address: City: State: Zip:

Phone:

Relative #2
First and Last Name: Relation:

Address: City: State: Zip:

Phone:

Non-Relative #1

First and Last Name: Address:

City: State: Zip:

Phone: Years Acquainted:

Non-Relative #2

First and Last Name: Address:

City: State: Zip:

Phone: Years Acquainted:


The applicant authorizes the owner/manager of Pine Shores Estates to contact past and present landlords, employers, creditors, credit bureaus, references and any other sources deemed necessary to investigate the applicant.

Credit and Criminal Investigation required on all applicants.

By initialing and submitting this application, you acknowledge that all information provided is true, accurate and complete to the best of applicant's knowledge. Owner/manager reserves the right to disqualify tenant if information is not as represented. This information is to be used only for the rental application process for Pine Shores Estates.

Applicant Initials: Today's Date: