Fill and Sign the Large Group Employee and Individual Application and Enrollment Form the Offering Companyies Listed below Severally or

16801 Newburgh, Suite 102, Livonia, MI 48154 info@nationalrealtycenters.com 734-432-2002 RENTAL APPLICATION – TO BE COMPLETED BY EACH ADULT OCCUPANT Rental Property Rental Property Address ___________________________________________________________________________ Personal Information Applicants Full Name _______________________________________ Social Security # ________________________ Date of Birth _______________ Drivers License # _____________________ State _____ Expiration ________________ Current Address __________________________________________________________________________________ Rent _____ Own _____ Total Monthly Payment __________________ How Long at Address ______________ Current Landlords Name ______________________________________ Phone # _______________________________ Reason for Leaving ________________________________________________________________________________ Previous Address _________________________________________________________________________________ Rent _____ Own _____ Total Monthly Payment __________________ How Long at Address ______________ Current Landlords Name ______________________________________ Phone # _______________________________ Reason for Leaving ________________________________________________________________________________ Employment / Income Present Employer __________________________________________ Position _______________________________ Name of Manager ___________________________________________ Phone # _______________________________ Address _________________________________________________________________________________________ How Long _______ Annual Income Year ______ $__________ Year ______ $__________ Year ______ $_________ Present Employer __________________________________________ Position _______________________________ Name of Manager ___________________________________________ Phone # _______________________________ Address _________________________________________________________________________________________ How Long _______ Annual Income Year ______ $__________ Year ______ $__________ Year ______ $_________ Additional Income ________________________________________________________________________________ How Long _______ Annual Income Year ______ $__________ Year ______ $__________ Year ______ $_________ Monthly Rent $_______________ Gross Monthly Income $_______________ Housing Ratio __________% Additional Information / Comments _________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Financial Information Monthly Payments: $__________ Auto Loan/Lease $__________ Medical Bill $__________ Other Monthly Rent $_______________ $__________ Child Support $__________ Student Loan $__________ Other Total Monthly Debt $_________________ $__________ Credit Card(s) $__________ Person Loan $__________ Other Debt Ratio __________% Additional Information / Comments __________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Personal History Have you ever been evicted from a lease? ___YES ___NO If yes, when and why _____________________________ ________________________________________________________________________________________________ Have you ever been involved in a property foreclosure? ___YES ___NO If yes, when and why __________________ ________________________________________________________________________________________________ Have you ever filed a petition for bankruptcy? ___YES ___NO If yes, when and explain ________________________ ________________________________________________________________________________________________ Have you ever been convicted of a felony? ___YES ___NO If yes, when and explain __________________________ ________________________________________________________________________________________________ Additional Occupants – All Adult Occupants Must Complete Their Own Application Form Total Number of Occupants _____ Name _________________________________ Name _________________________________ Name _________________________________ Name _________________________________ Relationship _________________________ Relationship _________________________ Relationship _________________________ Relationship _________________________ Age _______ Age _______ Age _______ Age _______ Pets Do You Have Any Pets? ___YES ___ NO If “Yes” Please Describe Type __________________ Breed __________________ Name __________________ Age _______ Weight _________ Type __________________ Breed __________________ Name __________________ Age _______ Weight _________ Personal References 1. Name ______________________________________________ Phone ____________________________________ Address__________________________________________________________________________________________ Relationship ______________________________ Occupation____________________________ Years Known_______ 2. Name ______________________________________________ Phone ____________________________________ Address__________________________________________________________________________________________ Relationship ______________________________ Occupation____________________________ Years Known _______ 3. Name ______________________________________________ Phone ____________________________________ Address__________________________________________________________________________________________ Relationship ______________________________ Occupation____________________________ Years Known _______ Authorization to Disclose Financial Information I hereby authorize National Realty Centers and any Agent associated with National Realty Centers to disclose all or any part of the financial information provided herein to any person or institution involved with the lease of said property. I also authorize National Realty Centers and any Agent associated with National Realty Centers, along with any prospective landlord, leasing agent, broker, credit bureau or management company to further investigate the information contained in this application, and/or obtain a credit report, and/or obtain any other tenant screening reports available from outside sources for use in connection with this application. All persons or entities entitled to use this information as stated herein or as is consistent with state or federal law may also use any information obtained or provided herein for purposes of litigation or obtaining or collecting upon any judgment against me. Any party may refuse to rent to me and may later lawfully terminate my tenancy if it is discovered that I have provided any false information herein whether that right is reserved in any lease or not. I hereby certify that the information provided herein is true and accurate to the best of my knowledge. _______________________________________ Applicant: ____________________________________ Date: