Application

If you would like to apply for an apartment, download a pdf here and fax to 212-581-9130
or
Please fill in the information below and then press the send button. All fields are required.

Please note that an application requires a $75 check prior to processing.
Please contact Mrs. Susan Virgadamo our head of leasing at 212-757-7500 ext. 109.


APPLICATION FOR OCCUPANCY
Building Name / Address:
Apt. #:
No. of Rooms:
Monthly Rent:
Security Deposit:

 

PERSONAL INFORMATION
Name:
SSID:

DOB:

In Case of Emergency Notify:
Mother's Maiden Name:

 

RESIDENTIAL INFORMATION
Present Address:
City:
State:
 Zip:
Phone#:
Rent:
Own:
 Length of Residence:
(YRS)
Rent/Mortgage Payment:
 Present Landlord or Mortgage Co:
 
Phone#:
 Address:
Mortgage Acct#:
Previous Address:
City:
State:
Zip:
Previous Landlord:
 Phone:
Term:
(YRS)

 

EMPLOYMENT
Employer:
 Address:
Supervisor:
Phone#:
Date of Hire:
Annual Salary:
Position Held:
 

 

FINANCIAL INFORMATION
Bank:
Phone#:
Address:
Checking Acct#:
Savings Acct#:
Contact:
Bank (2):
Phone #:
Address:
Checking Acct. #:
 Savings Acct #:
Contact:

 

BUSINESS REFERENCES
CPA Firm: Contact:
Phone#:
Law Firm: Contact:
Phone#:

 

OCCUPANTS
Adults:
Children:
 Pets:


I hereby allow the management company to perform a credit check on me and if applicable my company and I understand a $75 fee will be charged to me and payable by check within 1 week of this application being submitted.

I authorize Henry & Williams Co., Inc. . to conduct inquiries concerning my employment and income. References from landlords and mortgage institutions including Attorneys and CPA’s to furnish all information requested of you. IN compliance with the FCRA, I understand I may not view a copy of the report being furnished to the Landlord of Employer. I authorize to all above that a photocopy or facsimile copy of my signature and authorization will serve as an original. I agree that all the above information is true and that I am of legal age (18 years of age or above) to enter into this contract. I further agree that I am not renting an apartment under any other name and I have never been dispossessed. I agree that the owner/employer has the sole right to accept or reject this application. I understand that all processing fees are non-refundable.