Chambers Management, Inc. 377-1501
Residential Application
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Chambers Management Residential Application 

Chambers Management, Inc.

3343 Southgate Ct. SW #108

Cedar Rapids, Ia. 52404

 

Residential Application

Home phone:_________________ Cell phone:_________________Email:___________________________

Number of adults:_______ Number of children:_______ Number of pets:_______What kind?____________

Applicant’s full name:___________________________________________________________________

Date of birth:_______________________

Social Security Number:______________________________

Current address:_______________________________________________________________________

Length of tenancy:___________________________

Rent amount:___________________________

Reason for moving:_____________________________________________________________________

Present landlord/Company name:_______________________________ Phone number:______________

Previous address:______________________________________________________________________

Length of tenancy:___________________________

Rent amount:___________________________

Reason for moving:_____________________________________________________________________

Previous landlord/Company name:______________________________

Phone number:_____________

Current employment:_____________________________ How long?__________

Income:__________

Other source of income:________________________________________________

Income:__________

Vehicle #1________________________________________________

License #_____________________

Vehicle #2________________________________________________

License #_____________________

Have you ever been convicted of or pleaded guilty or no contest to a felony, whether or not resulting in a

conviction? Yes_____ No_____

If yes, please explain: ___________________________________________________________________

Are you on the sex offender registry or scheduled to be on the sex offender registry? Yes_____ No_____

If yes, please explain:____________________________________________________________________

 

Have you ever been convicted of or pleaded guilty or no contest to a misdemeanor, other than traffic offenses, weather or not resulting in a conviction? Yes_____ No______

If yes, please explain:____________________________________________________________________

 

Have you ever been evicted or refused to pay rent when due? Yes_____ No_____

If yes, please explain:____________________________________________________________________

Do you have any outstanding monies owed to a landlord? Yes_____ No_____

If yes, please explain:____________________________________________________________________

 

The above information is true to the best of my knowledge. I give Chambers Management my permission to check into my credit history with CSC credit services and any person listed as reference or landlord. In the event that any adverse action is taken in regards to this application based wholly or in part to your credit, you may obtain a copy of your credit report by contacting: CSC Credit Services, 652 N. Sam Houston Parkway, Ste. # 325, Houston Texas, 77060, or you may call them at 1-800-759-5979.

 

_______________________________________                ________________________

Applicant’s Signature                                                        Date

 

Application fee $20.00 (cash or money order)_________  Copy of photo ID__________

 

In processing the application, Chambers Management, Inc. may be looking at several qualifying areas for consideration.  These include, but are not limited to: Credit history, rental references, employment/income.  If the applicant has limited or adverse history, Chambers Management, Inc. may impose an additional deposit and/or monthly rent.

 

Limited history is defined as: Less than one year rental history and/or fewer than three qualifying credit accounts.

 

Adverse rental history is defined as: Poor rental payment history and/or rental reference.

 

Adverse credit history is defined as: two collection accounts and/or two delinquent revolving or installment accounts

 

Todd Chambers is part owner of Chambers Management Inc. and is a licensed real estate broker in the State of Iowa.

 

3343 Southgate Ct. #108 SW, Cedar Rapids, IA 52404