top of page

LEASE APPLICATION

 

Each adult applicant must complete the application below.

(NOTE: Each adult person that will reside in the rental property (occupants) must complete and sign a separate application form) (NOTE: All requests for information as set forth in this Application must be provided and any omission or misrepresentation of any information is automatic grounds for rejection of this application) (NOTE: Lessor does not deny or reject applications on the basis of race, color, religion, national origin, sex, ancestry, age, marital status, physical or mental handicap, familial status or any other class protected by Article 3 of the Illinois Human Rights Act or federal law.):

Birthday
Month
Day
Year

xxx-xx-xxxx

Have you ever been arrested, charged, or convicted of a criminal offense (excluding parking or traffic citations or juvenile matters)? (Check only one)
Have you ever been evicted or a lawsuit filed against you for eviction? (Check only one)
Have you ever, besides eviction, had a civil law suit filed against you (example: for money owed, etc)? (Check only one)
Do you have pets? (Check only one) NOTE: Lessor does not allow animals in leased premises without written permission of Lessor

By signing, I the undersigned applicant consents to and authorizes Brick City, LLC, its employees, contractors and agents, to obtain a copy of my credit report/history from the Credit Bureau or other any other applicable or similar consumer reporting agency and/or obtain any information from my current or any previous lessor or any other source. By signing, I the undersigned applicant understand that it is not a lease agreement, that no lease agreement is created herein and that I am at most a prospective tenant or occupant. By signing, I the undersigned understand that any fee paid by me is non-refundable, regardless of whether this application is approved or denied. By signing, I understand that in the event that my application is approved and a lease agreement is signed by me as a tenant that I must comply with all pre-possession conditions of the lease agreement. By signing, I represent that I have answered the above questions fully and truthfully. I understand that any misrepresentation of information on this application is grounds for eviction pursuant to the terms of the lease agreement.

Date and time
Month
Day
Year
Time
HoursMinutes

© 2019 Brick City       217-820-4168      231 A E Canedy St, Springfield, IL 62704

  • Instagram - White Circle
  • Facebook B&W
bottom of page