Burnham Rentals - 444 E. 3rd St. Suite 1 - Bloomington, IN 47401
- 812-339-8300 - 888-339-8301 - Fax: 812-332-1905
Office Hours: Monday - Friday 9:00 am to 4:30 pm - No pets please

Housing Application


First Name:	Middle Initial: Last Name:
Social Security #:	Date of Birth (1-1-1973):
Current Address:
Current City/State/Zip:
Current Home Phone:	Current Cell Phone:
Current Work Phone:
Current E-mail Address:
Are you a Student?	Yes No
What year & Major?
Will you be living in Bloomington in the Summer of 2010?	Yes No Unsure
Do you understand that we do not allow pets at our rental properties?	Yes
Names of Roommates:

Current Leasing Information
Location/Property Applying For:
Type of Unit your Looking for:	Efficiency 1 Bedroom 2 Bedroom 3 Bedroom Multi-Bedroom House
Have you ever rented a house or apartment:	Yes No
Previous Address:
What utilities where included:
Previous Landlord's Name:
Previous Landlord's Phone:
Rent Amount:
Have you ever been evicted from a rental unit?	Yes No If YES, why:

Permanent Information
Permanent Address:
Permanent City/State/Zip
Permanent Phone:

Payment Information
Share Your Responsibility for Rent?:

Employee Information
Current Employer:
Current Employers Phone:
Lenght of Time with Employer
Previous Employer:

Emergency Information (Parents)
Emergency Contact's Name:
Emergency Contact's Relationship:
Emergency Contact's Phone:
Emergency Contact's City/State/Zip:

	BASIC CONDITIONS OF LEASE FOR BURNHAM RENTALS 1. All lease contracts with Burnham Rentals are for a 360 day year period of time, unless otherwise denoted. 2. Applicants under the age of 21 are required to have a parent or guardian sign the lease. 3. No pets or visiting pets allowed. No waterbeds or dart boards allowed. 4. No loud noises, instrumental or vocal practicing, or large parties in rental units. All units shall be kept quiet enough as to not disturb neighbors. 5. The damage deposit paid at the signing of the lease is not to be considered as rent payment by the Lessee. The last month’s rent of a lease period must be paid within three (3) days of its due date. 6. At the check-out inspection, the rental unit must be left in as good as or better condition as recorded during the check-in inspection. After the check-out inspection is completed, the damage deposit will be returned to the person(s) paying the deposit no later than 45 days after the expiration of lease. 7. The rental unit may not be subleased without the specific written permission of Burnham Rentals. Subleasing the rental unit will not relieve the original Lessee(s) from their obligation for rental payments until the expiration of the original lease term. Lessor reserves the right to charge a sublease fee of $75.00. A rental unit may only be subleased once during the term of the contract. Conditions and terms for subleasing are available upon request from Burnham Rentals or their website. 8. The rent specified in the lease is the obligation of all persons signing the lease. In the event the full rent is not paid, all parties signing the lease will be held responsible, regardless of any partial payments made. 9. In the event that Burnham Rentals (either through court action or agreed terms with the Lessee(s)) requires the Lessee(s) to vacate the rental unit prior to the expiration of the lease, the Lessee(s) is/are responsible for any rent (past, current or future) and any unpaid utilities due under the terms of the lease. 10. Rental occupancy is limited to the named individuals and number specified in the lease. I have read the above application and understand that the conditions specified above are not inclusive, and there are other conditions in the lease itself. The completion of this application creates no obligation on the part of Burnham Rentals or the applicant. It is understood that any misrepresentation of information provided by the applicant on this form will automatically disqualify the applicant from signing a lease with Burnham Rentals. I hereby authorize, for verification purposes, the release of any information provided to the Burnham Rentals in this application. Date I Agree (Please Type this In the Box to the Right): Applicant

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Burnham Rentals - 444 E. 3rd St. Suite 1 - Bloomington, IN 47401
812-339-8300 - 888-339-8301 - Fax: 812-332-1905

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