unlocking central Illinois apartments you can call home

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702 Jackson St. Apt B Henry, IL $575/Month

Legal Name *

First

Last

Date of Birth *

Email *

Phone Number *

Current Address, City, State, Zip Code *

Which best describes your current living situation? *

Renting
Own
Living rent free

What is your currently monthly housing payment? *

What was the move-in date for your current residence? *

Any other previous addresses in the last 5 years?

What dates did you live at this address/addresses?

What is your current main source of income/or employer's name? *

How long has this been your main source of income? *

Do you have a second source of income? *

Who was your previous employer, and what were your dates of employment? *

What is the current balance of your bank account that you could use toward housing as of today? *

Which of the following describes my vehicle? *

I do not own a vehicle
I make monthly payments on a vehicle (owned or leased)
I own a vehicle but do not have monthly payments for this vehicle

Will there be any other adult-occupants living in the apartment who will be responsible for paying a portion of rent? *

Yes
No

Will there be any other occupants living in the apartment who will not be responsible for paying rent? If so, please describe the number, relationship to you, etc.

Have you been evicted from a home in the last 5 years?

Yes
No

Have you had any liens, judgments, bankruptcies, or foreclosures filed against you in the past five years?

Yes
No

Have you been convicted of any non-traffic crimes in the last 5 years?

Yes
No

If you've answered yes to either of the last three questions, please provide a further explanation. Additionally, what changes have you implemented to prevent either scenario from occurring again?

Are you a smoker of tobacco products? *

Yes
No

Do you have any pets that will be living on the premises? *

Yes
No

By checking this box, I consent to have my records searched in both public and private databases. *

I consent