To apply for Ridge Creek apartments, please e-mail paula@oroszproperties.com or call 608-242-8912. Address Applying For * - Select -The Embassy 26 North Breese Terrace 1610 Chadbourne AvenueAurora PointeBedford Crossing419 North Pinckney Street505 Conklin PlaceWest Johnson Street HousesNorth Bassett Street HousesDrake Street Houses26 North Breese Terrace/1610 Chadbourne AvenueRoyal Arms Apt. # Rent Security Deposit Amount Special Terms or Conditions (Renovations required, pets, etc.) Applicant's Email Address * All information requested below must be provided in order to process this application. Applicant is entitled to review the lease, rules and regulations, previous tenant damages, and other forms as may be required by law for occupancy, and in signing this form attests that this information has been provided to their satisfaction. The Fair Credit Reporting Act, Public Law 91-508, requires that we notify you that as a part of our normal procedure, routine inquiries will be made to provide information concerning character, general reputation and style of living. Upon written request, the nature and scope of any report, if one is made, will be provided. Do you wish to receive a written explanation of a denial of tenancy? Yes No Name of Person(s) To Occupy Apartment (All occupants must be listed if more than one). 1. * Birth Date * Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 SS# Phone # * 2. Birth Date Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 SS# Phone # 3. Birth Date Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 SS# Phone # 4. Birth Date Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 SS# Phone # 5. Birth Date Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 SS# Phone # Present Address How Long? Rent Paid Present Landlord How Long? Phone # Previous Address How Long? Rent Paid Previous Landlord How Long? Phone # Employed By How Long? Phone # Position Supervisors Name Applicant's Income/Monthly Credit References Name Address Telephone # Bank Name Car Make License Plate # Drivers License # Emergency Name Relationship Telephone # Street Address City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Receipt in the sum of $ is hereby acknowledged. This deposit will be returned to the undersigned if this application is not accepted. If accepted, this sum will then be applied to the security deposit required and/or the first month’s rent. All applications are subject to approval of owner or managing agent. Upon acceptance, applicant agrees to pay the balance of any amount due on the security deposit, plus the first full months rent. If the applicant refuses to sign the lease after this application has been approved, OR does not take occupancy, they forfeit the costs of application processing and advertising. In signing this form, they attest that they have never been evicted or declared bankruptcy. Applicant understands that this form is NOT a rental agreement or contract. Date Year Year20222023202420252026 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Applicant's Signature Rental Agent In case of emergency contact the following FAMILY MEMBERS: Leave this field blank
