American Family Communities

Application

Application Process: Please fill out the application completely. Each applicant will be asked to supply copies of last 2 current paystubs and a copy of their driver's license. There is a $35 non-refundable application fee for each applicant that is payable at the time the application is filled out. Payment must be in the form of a money order or credit card.

Once the application and all fees have been received please allow 24 hours to pre-qualify you for your new home.

Primary Applicant

First Name
Last Name
Date of Birth	(mm/dd/yyyy)
Home Phone
SSN
Address
City
State
Zip
Email

Current Landlord's Name
Landlord's Phone
How long at this address
Reason for leaving
Previous Address
Previous City
Previous State
Previous Zip
Previous Landlord's Name
Previous Landlord's Phone Number
How long at this address
Reason for leaving

Driver's License #
State Issue
Expires
Vehicle Make/Model
Year of Vehicle
License Plate

Present Employer
Work Phone
Employer's Address
Employer's City/State
How long at this job
Gross Monthly Income
Other Income

Co-Applicant

First Name
Last Name
Date of Birth	(mm/dd/yyyy)
Home Phone
SSN
Address
City
State
Zip
Email

Current Landlord's Name
Landlord's Phone
How long at this address
Reason for leaving
Previous Address
Previous City
Previous State
Previous Zip
Previous Landlord's Name
Previous Landlord's Phone Number
How long at this address
Reason for leaving

Driver's License #
State Issue
Expires
Vehicle Make/Model
Year of Vehicle
State License Plate

Present Employer
Work Phone
Employer's Address
Employer's City/State
Employer's Zip
How long at this job
Gross Monthly Income
Other Income

PLEASE NOTE: Any other applicants over the age of 18 must complete and sign their own application.

Have either you or the co-applicant ever been party to an eviction? Yes No

Total number of adults (anyone over 18)
Total number of children living with you (under the age of 18)

Names and relations of all other applications desiring residency:

Name	Relationship	Date of Birth	Social Security #
1.
2.
3.

Mobile Home Information

Year	Make/Model	Size	VIN#	Condition	Elec. Breaker Req.

Home is being financed through (lender)
Lender's Address
How did you hear about us?

Pets

Type and Breed	Age	Color	Height (at shoulder)	Weight
1.
2.
3.

Emergency Contact Information

Name	Address	Home Phone	Alternate Phone

Applicants CERTIFY that answers given herein are true and complete to the best of their knowledge. Applicants authorize American Family Communities, LLC, and other third parties that may be hired to verify applicant's employment, rental references and /or run credit and criminal history checks. Applicants are aware that questions will be asked regarding applicant's background and applicants give their permission to do so. Applicants understand that the landlord may terminate any rental agreement entered into for any misrepresentation made above. Applicants agree to sign a Lease, Rules and Regulations, and any other form the community may require prior to moving into the community if this application is approved. All applicants must agree to obey all rules in order to be approved and remain in the community.

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