Free Security Deposit Resident Application

Please fill out all of the following questions as accurately as you can. Even a negative answer will not disqualify you but will help us to place you in the proper qualification system. It is our objective to help you find a new rental home with no security deposit and discounted rent. Your honesty through this process will speed up our capabilities. Please submit this information to us as quickly as possible. We have a limited number of vacancies to fill.

Are you ready to move within the next 45 days?
Yes   No
Do you know which property you want to move to:
Yes   No

If you answered yes to both of the above, please list the information for the property you wish to move to. We will have an Agent contact the property and negotiate a discount in your rent and eliminate the need for any security deposit. All you have to do is follow our simple process. If you are not ready to move or do not know where you would like to move remember our website and return when you are ready. Please list the property contact information as completely as you can:

Desired New Location

Property Name:
Address (if known):
City:
State:
Zip:
Property Phone Number:
Ext.
What size rental unit are you interested in?

1 Bedroom

2 Bedroom

3 Bedroom

Other:

Your Personal Information

Resident's Full Name

First:
Middle:
Last:
Phone Number:
Ext.
Email Address:

Date of Birth:

Month:
Day:
Year:

Social Security Number:

e.g. xxx-xx-xxxx

-
-

Present Address

Address: 
Apt./Suite:
City:
State:  
Zip:
Property Phone Number:
Current Landlord Name:
Landlord Telephone Number:

Dates of Occupancy

From:

Month
Day
Year

To:

Month
Day
Year
Please explain any known reasons for late payments or problems over the previous 12 months only with this Landlord:

Present Employer

Company Name:
Employer Contact Name:
Employer Telephone #:

Employed Since:

Month:
Year:
Income Per Week($):
Income Per Month($):
Annual($):

Past Employer

If you have had more than one employer over the last year please list the additional employment information below.
Company Name:
Employer Contact Name:
Employer Telephone #:

Employed From:

Month:
Year:

Employed To:

Month:
Year:
Income Per Week($):
Income Per Month($):
Annual($):


Other Past Employer

Company Name:
Employer Contact Name:
Employer Telephone #:

Employed From:

Month:
Year:

Employed To:

Month:
Year:
Income Per Week($):
Income Per Month($):
Annual($):
Any additional employment information or explanations:

Additional Income and Expenses

Please list and describe any other sources and amounts of income. This includes child support, social security, disability, food stamps, section 8, non-lease spousal income or any other documented income.

List Other Income Source
Income per Month($)

Duration of Expected Income

From:

Month
Day
Year

To:

Month
Day
Year

List Other Income Source
Income per Month($)

Duration of Expected Income

From:

Month
Day
Year

To:

Month
Day
Year

List Other Income Source
Income per Month($)

Duration of Expected Income

From:

Month
Day
Year

To:

Month
Day
Year

List Other Income Source
Income per Month($)

Duration of Expected Income

From:

Month
Day
Year

To:

Month
Day
Year

List Other Income Source
Income per Month($)

Duration of Expected Income

From:

Month
Day
Year

To:

Month
Day
Year

Total Additional Income per Month($):
Your current monthly income that is verifiable is($)
Your current monthly expenses that are verifiable are($)

Can You Afford Your New Apartment

These next two questions will be verified so please answer accurately.

Have you ever been evicted from an apartment?
Yes   No
If the answer is yes it will not disqualify you from our system.
Please give a detailed explanation of why you were evicted:

Have you ever been convicted of a felony?
Yes   No
If the answer is yes it will not disqualify you from our system.
Please give a detailed explanation of the reasons for your conviction:

By signing or digitally submitting my name below, I acknowledge that I am hiring Assurance Protection Group LLC. (referred to as APG), doing business as www.freesecuritydeposit.com, as my representative to find rental housing for me with no security deposit and discounts. I am under no obligation to accept the rental housing (APG) offers me and can find my own rental housing with no obligation to (APG). If I do accept rental housing offered to me by (APG), I agree to follow the instructions given to me by APG in the execution of the Lease Agreement with the Landlord. I hereby authorize Assurance Protection Group, LLC. and their assigns to run credit reports and background checks on me:

Type Your Full Name
Security Code:
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