8 Month $300 Rent Rebate Room Rental Form-
When do you need to Move into your home?
within 10 days
the 1st of the next month
Type of room your requesting?
One room Single Occupancy with share bathroom, kitchen, and Living room
I need to rent 2 or more rooms in the same home
Couple or double occupancy $480 and UP
IF a private bathroom is available I would prefer this ( rent will be $425 and up)
Renters Full Name
City, state, Zip
Best Phone Contact Number
Best way to reach you?
For identification purposes what is your birthdate on your GA Vaild ID?
Do you have a criminal history? if yes does it include sex crimes? Violent crimes? ----
have you ever been to Fulton Co. Jail, Dekalb, Cobb, or Gwinett? if so which, when and what were the charges
Are you on Probation? is so where, Probation officer name and number.
For identification purposes what is your social security number? -
Will you be living in your Room alone or have a partner or guests? (no more than 2 individuals allowed in the room)
I will have a guest 1 to 2 nights a month (extra charge)
I have a partner that will be there frequently (extra charge)
I have a partner that will be there over 40% of the time - Double Occupancy
Drug usage and behaviors that lead to one to believe drug usage is present, will not be tolerated!
I have never used drugs
I have been clean for more than 6 months
I have been clean for more than one year
I will not use or bring drugs into the home
How many Cars/trailers space would you need?
None I/We don't own a car
only a guest rarely
Anything else about you or your situation we should be aware of?
how much Deposit can you put down?
$250 (increase rent $25 dollars - $15 goes towards deposit)
$200 (increase rent $30 - $15 goes towards deposit)
$150 (increase rent $30 dollars $10 goes towards deposit)
$100 (increase rent $30- $5 goes towards deposit)
>>>Why are you moving and why do you need to rent on a weekly and monthly basis?>>>>>
Are you or anyone in your household receiving Government Benefits of any kind, such as SSDI, SSI, VA, etc. If so who, what, and how much?
Do you have Proof of Income (a job or SSI/SSDI/WC ect.?)
Yes from a Job
No- we cannot rent without knowing you can pay!!!
Other Government check
Current Occupation and years of experience, if none put in none.
what is your gross monthly income from all sources, include your significant as well as others that will be living there if they are helping you purchase
how much cash do you have now?
Must bring Valid Ga ID and Proof of Income
Is there anything pending in your life that would affect your ability to pay rent over the next 6 months?
how long are you expecting to rent
How did you hear about us?
Atlanta Journal Constitution
Friend or word of month
Only neat, clean, respectable, drug free individuals that pay their rent on time may apply
I can meet these standards
I am not able to follow this
To qualify for the $300 rent rebate!