Greensboro Property Management, Greensboro Property Managers, Greensboro Property Management Companies. HomeRiver Group® Triad

The undersigned hereby submits an application to lease the following property under the terms and conditions of the Birch Management lease. A sample copy can be found in the forms section of our website.

In order for the online application to be accepted, a non-refundable online application fee of $50.00 must be paid with either a credit or debit card. The submitted application and fee are valid for 30 days from date of receipt.

General Information

Desired Property Information

Property Address

Lease Start Date Lease End Date Monthly Rent

Personal Information

First Name Last Name Street Address Suite/Apt #
City State Zip Date of Birth
Home Phone Work Phone Cell Phone SSN
Monthly Income Additional Sources of Funds Country of Citizenship Email
How Did You Hear About Us?

Dependents Under 18 Years Of Age

(All occupants 18 and over must submit an application)
Dependant 1 Name DOB Relation
Dependant 2 Name DOB Relation
Dependant 3 Name DOB Relation

Pets

Type Breed Size (lbs.) Color Type Breed Size (lbs.) Color Type Breed Size (lbs.) Color

Rental History

Rental 1

Date Start Date End Owner/Agent Owner Phone
Street Address City State Zip
Reason For Leaving

Rental 2

Date Start Date End Owner/Agent Owner Phone
Street Address City State Zip
Reason For Leaving

Rental 3

Date Start Date End Owner/Agent Owner Phone
Street Address City State Zip
Reason For Leaving

Rental 4

Date Start Date End Owner/Agent Owner Phone
Street Address City State Zip
Reason For Leaving

Employment Information

Current Employment

Date Start Date End Employer Name Title
Supervisor Phone Address Salary

Former Employment

Date Start Date End Employer Name Title
Supervisor Phone Address Salary

Financial Information (If you wish for it to be considered for your application decision)

Assets

Asset (Bank Account, Etc.) Type Amount Telephone
Asset (Bank Account, Etc.) Type Amount Telephone
Asset (Bank Account, Etc.) Type Amount Telephone
Asset (Bank Account, Etc.) Type Amount Telephone

Liabilities

Liability (Credit Card, Loan Etc.) Monthly Payment Balance Due
Liability (Credit Card, Loan Etc.) Monthly Payment Balance Due
Liability (Credit Card, Loan Etc.) Monthly Payment Balance Due

Contingency Items

By submitting this application, I certify that I accept the property in as-is condition, unless specified below.

Should you desire to request any minor repairs, please read the below statement and list them below.

I have personally inspected the above referenced property and am submitting this application to lease the property, but request that the following repairs be considered prior to occupancy. If the items below are approved by the landlord, they become mutually agreed to conditions of the Residential Rental Contract (Lease) and are to be agreed upon by both parties on the condition that at least (10) days exist between this agreement and occupancy. Please note the Landlord and/or Agent reserve the right to negotiate and seek an increased monthly rental rate if the repair contingencies are in excess of $200.00.

It is further acknowledged that Agent does not have the authority to approve, or disapprove, the requests.

Contingency #1 Contingency #2 Contingency #3 Contingency #4

Other Information

Vehicle Information

License Plate # State Make Model
Year Description (color etc.) Driver's License # State

Additional Information

Have You Ever Filed For Bankruptcy? If Yes, When? Have You Ever Been Evicted? If Yes, When?

Emergency Contact

Name Phone

Authorization

Yes, I have read and agree with the terms of Birch Management & I agree to a $50.00 (includes convenience fee) non-refundable Application fee.
(view terms before accepting agreement)
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HomeRiver Group® Triad
- 1205 W Bessemer Ave #210
- Greensboro, NC 27408
Phone: 855.744.4268
Triad@homeriver.com

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HOMERIVER GROUP and the HOMERIVER GROUP Logo are registered trademarks, used with permission. HomeRiver Group fully supports the principles of the Fair Housing Act and the Equal Opportunity Act.

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