Home > Our Forms > Grand Lux Realty Rental Application
Grand Lux Realty, Inc.
428 Main St.
Armonk, NY 10504
T-914-273-9688
F-914-765-0518
APARTMENT RENTAL APPLICATION:
Application Fee: $_________________________Deposit: $_________________________
Check: #_________________________
Property Address:__________________________________________________
Number of Bedrooms:_________________________
Price Range: $_________________________
Name:__________________________________________________
Current Address:__________________________________________________
How long at this address?:_________________________
Social Security: #_________________________
Date of Birth:_________________________
Telephone: #_________________________Cellphone: #_________________________
Present Landlord:__________________________________________________
Landlord Telephone: #_________________________
Reason for leaving current address:_________________________
Do you have a savings account? Yes No
Do you have a checking account? Yes No
REFERENCES:
Name:_________________________Tel:_________________________
Name:_________________________Tel:_________________________
Applicant’s Employment Information:
Current Employer:_________________________
Supervisor Name:_________________________
Employer Address:__________________________________________________
Employment Start Date:_________________________
Number of years employed:_________________________
Employer Telephone: #_________________________
Annual Income:_________________________
Co-Applicant’s Information (Spouse or other):
Name:_________________________
Social Security: #_________________________Date Of Birth:_________________________
Current Address:__________________________________________________
How long at this address?:_________________________
Telephone: #_________________________Cellphone: #_________________________
Present Landlord:__________________________________________________
Landlord Telephone: #_________________________
Reason for leaving current address:_________________________
Do you have a savings account? Yes No
Do you have a checking account? Yes No
Co- Applicant’s Employment Information (Spouse or other):
Current Employer:_________________________
Supervisor Name:_________________________
Employer Address:__________________________________________________
Employment Start Date:_________________________
Number of years employed:_________________________
Employer Telephone: #_________________________
Annual Income:_________________________
Other Occupants (children, if any):
Name:_________________________Age:_________________________
Name:_________________________Age:_________________________
Name:_________________________Age:_________________________
Please answer all questions:
Do you receive public assistance? Yes No
Type:_________________________How long?:_________________________
City:_________________________
Have you ever been subject to a collection action on credit accounts? Yes No
If yes, when?:_________________________
Have you ever been evicted or asked to leave a rental property?: Yes No
If yes, when and why?:_________________________
Have you ever filed bankruptcy?: Yes No
If yes, when?:_________________________
Have you ever been convicted of a crime?: Yes No
If yes, what?:____________________
Terms of Agreement:
In consideration for Grand Lux Realty acting as finding agent of an apartment, the undersigned agrees to pay a broker's fee equal to one month's rent. The fee is due and fully payable upon lease signing and is non-refundable.
Applicant Signature:_________________________Date:____________________
Co-Applicant’s Signature:_________________________Date:____________________
