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1 APPLICATION PROCESS 1. APPLICANT: A complete application is required for each adult 18 years of age and older. All adult applicants must completely and accurately fill out a separate application. Applications will not be processed unless all parties applying for the unit have submitted completed applications. If any information on the application is false or withheld, the application will NOT be approved. If misrepresentations are found after a rental agreement is signed, your rental agreement will be terminated. 2. IDENTIFICATION: All applicants are required to provide photo identification such as a valid driver s license or state identification card at the time the application is turned in for processing. 3. EARNEST MONEY: Submit the completed application along with $150 earnest money deposit (check or money order made payable to: Birwood, LLC NO CASH PLEASE) to our office at 2510 Pennsylvania Ave, Madison, WI The $150 earnest money check will be deposited into the Birwood Trust account. If your application is approved the full earnest money will be applied to your security deposit. If you withdraw your application once submitted or you are denied, a $20 application fee per applicant will be deducted to cover the cost of the credit report and the remainder of the earnest money will be reimbursed once the check(s) have cleared the bank (approximately 5 to 7 business days). 4. HOUSING VERIFICATION: Applicants must have a minimum of 12 months of successful rental and rent payment history. We check references from landlords to determine an applicant s rent payment history and behavior. Friends and family are NOT considered acceptable housing references. If the applicant has been filed on for an eviction, evicted from a previous apartment during the last five years, owes any judgments or has an outstanding balance owed to any current or past landlord, the applicant will NOT be accepted. Applicants with less than 12 months of housing history may be required to obtain a co-signer to guarantee the financial obligations of the lease. 5. INCOME VERIFICATION: We verify income and use a monthly income guideline of three times the monthly rent in our screening process. Applicants must demonstrate an ability to pay the monthly rent. Please list all sources of income you wish to have considered. If an applicant receives an income subsidy, the applicant must provide verification when turning in the completed application. Applicants who are self-employed will be asked to submit tax returns for verification. If an applicant does not demonstrate the ability to pay the monthly rent, a co-signer may be required to guarantee the financial obligations of the lease. 6. CREDIT REPORT: A credit check will be conducted on the applicant. Unpaid medical and student loans will not be a cause for denial but a poor credit report, as it relates to total debts, rent, utility payments, and judgments against the applicant may result in denial or require a qualified co-signer. 7. BACKGROUND CHECK: We review criminal backgrounds of all applicants, to ensure the safety & security of our current residents and the premises. Any criminal records may be ground for denial. 8. APPLICATION PROCESS TIME: All necessary rental references, employment verifications, and/or guarantor forms must be completed within 3 business days from the landlord s receipt of applications. If the above requirements are not met the landlord retains the right to declare the application null and void. A $20 application fee per applicant will be deducted. 9. APPROVED APPLICANTS: All applicants have 5 business days upon notification of application approval to sign the lease documents and pay the remainder of the security deposit in full. If the above requirements are not met the landlord retains the right to declare the application null and void. A $20 application fee per applicant will be deducted from the earnest money. Page 1 of 5

2 LANDLORD DISCLOSURES AND REQUIREMENTS Applicant Acknowledges Having Been Advised 1. The check for the earnest money collected is the receipt for the applicant. 2. Copies of the proposed lease and Rules & Regulations of the landlord have been made available to applicant for review. 3. I have been given the name and address of the person authorized to receive rent, manage, and maintain the premises, who can readily be contacted, and an owner of agent with an address within the state authorized to receive and receipt for notices and demands, and at which service of process can be make a person. 4. I have been advised of my right to inspect the dwelling unit and notify the landlord of any damage or defect that exist before the beginning of my tenancy. 5. I have been advised of my right to request, in writing, a written list of the physical damage and defects, for which the landlord deducted money from the previous tenant s security deposit. 6. I have been advised of utility charges not included in the rent. Utility Charges Electric Heat Water/Sewer Gas AC Hot Water Trash Included in Rent Metered Separately Cost Allocation 7. I have been advised that the landlord has actual knowledge of the following uncorrected building code or housing code violations that present a significant threat to the prospective tenant s health or safety. Adverse Condition: Yes (Explain) No No Hot or Cold Running Water Plumbing Facilities Not in Good Operating Condition Sewage Disposal Facilities Not in Good Operating Condition Unsafe Heating Facilities Capable of Maintaining a Temperature of 67 F Electrical Wiring, Outlets, Fixtures Not in Safe Operating Condition Other 8. Landlord promises to repair, clean, or improve the premises as follows by the completion dates noted: 9. Security deposits may be withheld only for tenant damages, waste or neglect of the premises of the non-payment of rent, utility service, or mobile home parking fees for which the Landlord becomes liable and other reasons specifically and separately negotiated and agreed to by the tenant in writing in a Nonstandard Rental Provision. LANDLORD DISCLOSURES AND REQUIREMENTS (City of Madison Ordinances) 10. That a copy notice of eligibility for rent abatement, if any, which affects the rental unit of common areas has been provided the tenant. 11. That the occupancy limit imposed upon the dwelling unit by of the City of Madison General Ordinance is. However, occupancy is restricted to those persons named in the application and the rental agreement. 12. That the definition of a family pursuant to 28-03(2) Madison General Ordinances, is as follows: A family is an individual of two or more persons related by blood, marriage, or legal adoption living together as a single housekeeping unit in a dwelling unit, including foster children, and not more than four (4) roomers except that the terms family shall not in R1, R2, R3, R4A and R4L residence districts include more than one (1) roomer except where dwelling unit is owner occupied. For the purposes of this section children go means natural children, grandchildren, legally adopted children, stepchildren, foster children, or a ward determined in a legal guardianship proceeding. Up to two (2) personal attendants who provide services for family members or roomers who, because of advanced age of a physical or mental disability, need assistance with activities or daily living shall be considered part of the family. Such services may include personal care, housekeeping, meal preparation, laundry or companionship. 13. That the zoning district in which the dwelling unit is located is. 14. That the off-street parking requirements of the dwelling unit pursuant to Madison General Ordinances is. Except in the central area as per section 28.07(1)(g) of the Madison General Ordinances. *** PLEASE KEEP THESE TWO PAGES FOR YOUR REFERENCE *** Page 2 of 5

3 ID CHECK $150 APP CHECK BY: Date: RENTAL APPLICATION UNIT INFORMATION Apartment Address & Unit #: Monthly Rent $ Security Deposit $ Lease Dates to Does Property Accept Pets? YES NO Tenant is responsible for the following utilities and responsibilities: Heat Electric Gas Hot Water Cold Water AC Trash Snow Lawn APPLICANT INFORMATION Each Adult Applicant Must Complete a Separate Rental Application Application must be completed in full. Falsification of information is grounds for denial. Name: First, Middle, Last (Maiden) Date of Birth Drivers License # Social Security # Cell/Home Phone Work Phone Names of other persons to occupy unit Relationship Date of Birth (If under 18) YES NO Do you expect any additions to the household within the next 12 months? Name & Relationship Do you have or anticipate having any pet(s) to occupy unit if allowed at property? If so, how many and what kind? Have you ever failed to pay rent when due? Do you currently owe past due rent of other monetary obligations to your current landlord of previous landlord? Has an eviction action ever been filed against you? If yes, by whom, when, and for what reason? Have you been convicted of a crime involving violence to persons or property in the last 3 years? Have you been convicted of any drug-related offenses in the last 3 years? Page 3 of 5

4 EMERGENCY CONTACT Name Address City State Zip Phone # Relationship I hereby authorize management to release information to the above mentioned person regarding my: Medical /Emergency Care/Safety Concern Payments/Tenant Ledger Leasing Terms/Renewal APPLICANT S RENTAL HISTORY (Past Two Residents) If you do not have any rental history, please still provide us with your current permanent address. CURRENT Address City State Zip Since (date) Rent Amount $ Number of Roommates Landlord Name Landlord Phone # PREVIOUS Address City State Zip From (date) To (date) Rent Amount $ Number of Roommates Landlord Name Landlord Phone # APPLICANT S EMPLOYER & INCOME PRESENT Employer Position Address Phone # Managers Name Start Date Monthly Pay $ Hours worked per week Full Time Part Time PREVIOUS Employer Position Address Phone # Managers Name Start Date End Date Monthly Pay $ Hours worked per week SELF EMPLOYED APPLICANTS: If you are self employed you will need to provide the following information: Tax returns, business license, bank records and/or vendor names, with addresses and phone numbers for verification. OTHER SOURCES OF INCOME Will you be receiving any other income that you want considered with this application (ex. Section 8 Rental Assistance, SSI, Social Security, public assistance, W-2, alimony, child support, savings, trust funds, scholarships, student loans or any other type of income)? If so, please provide information below along with documentation for verification. * You do not have to reveal alimony or child support unless you want it considered as part of your income on this application. Amount Source Confirmation Person Phone # Have you ever filed for bankruptcy? Yes No Page 4 of 5

5 PLEASE READ CAREFULLY AND SIGN THIS APPLICATION The purpose of this application is to determine whether I qualify as a tenant. If my application is approved, the Landlord and I shall sign a written lease or rental agreement. The Landlord and I have no rental agreement until the time that the lease or rental agreement is signed. I have read and understand the application standards and the application process. I have paid the earnest money deposit. If my application is approved the full earnest money will be applied to my security deposit. If my application is approved, and I fail to enter into a lease agreement, the earnest money and any subsequent payments may be retained to compensate the Landlord s costs and damages, subject to the Landlord s duty to mitigate. If my application is denied, $25 per applicant will be deducted. Any remaining funds will be reimbursed when the check(s) have cleared the bank (approximately 5 to 7 business days). I hereby authorize the Landlord/Manager to investigate my credit/financial responsibility, income, rental and eviction history, and the statements made in this application, and to obtain a consumer credit report on me from a consumer reporting agency that complies and maintains files on a nationwide basis. My performance under any lease or rental agreement that I may enter into with the Landlord may be reported to such reporting agency. I acknowledge that the Manager and the agents and employees thereof represents the interests of the Landlord, but they also have a duty to treat all parties fairly and in accordance with fair housing law, and to disclose material adverse facts about the property. I was given the opportunity to review a sample lease or rental agreement, and the Landlord s rules and regulations. I warrant and represent that I am at least 18 years of age and that all statements herein are true and complete to the best of my knowledge. I have been advised that the landlord has actual knowledge of the following uncorrected building code or housing code violations that present a significant threat to the prospective tenant s health or safety. I acknowledge that false, inaccurate or incomplete information will result in the denial of this application. Notice: You may obtain information about the sex offender registry and persons registered with the registry by contacting the Wisconsin Department of Corrections on the Internet at or by phone at Signature Date How did you hear about the apartment/house? Were you referred to Birwood by one of our residents? Yes No If so, please provide their name so we can thank him or her PLEASE RETURN YOUR APPLICATION AND EARNEST MONEY DEPOSIT TO BIRWOOD PROPERTY MANAGEMENT. IF SENDING IT VIA FAX OR PLEASE SEND A COPY OF THE EARNEST MONEY CHECK AND THEN MAIL ALL ORIGINALS Pennsylvania Ave Madison, WI info@birwood.net Page 5 of 5

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