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A statement about security and your privacy: In an effort to speed up the application process, Hallock Properties, LLC. invites you to fill out an application and send it to us electronically. The benefit is that we recieve a completed, neat application and can get the administrative duties out of the way as quickly as possible to get you into your rental property. When you click "Submit Application", the data is encrypted and sent securely to our office using PGP secure email technology. Our web architecture firm, has provided us with a secure line to ensure the 128-bit Secure Socket Layer encryption process.

If you do not feel comfortable filling out this application online, you may print a copy of our application and landlord reference form here (requires Acrobat Reader)
HALLOCK PROPERTIES
303 E. WASHINGTON STREET, MEDINA, OHIO 44256
330-722-3055

Applicant: The approval of your application is contingent upon the receipt of verification of employment or other income and the receipt of an acceptable former landlord reference. If you are currently a rental tenant, we require your signature on the attached landlord reference form authorizing your landlord to complete your tenant reference as required. Incomplete applications will not be accepted.
EMAIL ADDRESS(required): July 30, 2010 09:35 am EDT
INQUIRED PROPERTY ADDRESS:
APPLICANT: PHONE: S.S. NUMBER:
PRESENT ADDRESS: HOW LONG?:
LANDLORD`S NAME: PHONE:
LANDLORD`S ADDRESS:
FORMER ADDRESS: HOW LONG:
FORMER LANDLORD: PHONE:
FORMER LANDLORD`S ADDRESS:
APPLICANTS EMPLOYERS: MONTHLY INCOME:
EMPLOYERS ADDRESS: PHONE:
OCCUPATION: LENGTH OF SERVICE:
APPLICANTS NEAREST RELATIVE: PHONE:
CO-APPLICANT: PHONE: S.S. NUMBER:
PRESENT ADDRESS: HOW LONG?:
LANDLORD`S NAME: PHONE:
LANDLORD`S ADDRESS:
FORMER ADDRESS: HOW LONG:
FORMER LANDLORD: PHONE:
FORMER LANDLORD`S ADDRESS:
CO-APPLICANTS EMPLOYERS: MONTHLY INCOME:
EMPLOYERS ADDRESS: PHONE:
OCCUPATION: LENGTH OF SERVICE:
CO-APPLICANTS NEAREST RELATIVE: PHONE:
ADDITIONAL OCCUPANT:
ADDITIONAL OCCUPANT:
TOTAL NUMBER OF OCCUPANTS:
NUMBER OF DOGS: WILLING TO PAY A PET FEE? Yes No
NUMBER OF CATS: WILLING TO PAY A PET FEE? Yes No
HAVE YOU GIVEN 30 DAYS NOTICE TO MOVE? Yes No
HAVE YOU PAID THIS MONTHS RENT? Yes No
ARE YOU BEING EVICTED OR ASKED TO LEAVE THE PREMISES? Yes No
DO YOU HAVE DEPOSIT AND FIRST MONTH RENT? Yes No
WHAT IS YOUR PREFERRED MOVE IN DATE?
WHY ARE YOU MOVING?

PLEASE READ CAREFULLY BEFORE SUBMITTING


The undersigned warrants and represents that all statements herein are true and agrees if accepted to execute upon presentation of a lease agreement in the usual form and on the terms and conditions therein stated, which lease or agreement may be terminated by the Landlord in any statement made herein is not true. Applicant and Co-Applicant each must acknowledge.
Applicant: Co-Applicant:

AUTHORIZATION TO VERIFY PERSONAL REFERENCES


I/We do hereby authorized Hallock Properties and its employees to contact my references to verify my personal reference herein stated.
Applicant: Co-Applicant:
Validation Code:
(case sensitive)
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