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HORSE CREEK VILLAGE RENTAL APPLICATION
Thank you for your interest in Horse Creek Village! This community is open to
Polk residents only
.
No pets allowed
.
* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
Telephone Number
*
Your answer
Last four of your social security number
*
Your answer
Are you currently a resident of Polk County, NC?
*
Yes
No
Current Physical Mailing Address
*
Your answer
Do you receive mail at your physical mailing address?
*
Yes
No
If you answered no above, please provide mailing address.
Your answer
How many bedrooms do you currently have?
*
Choose
Homeless/Shelter
1
2
3
4
5
Do you have any pets?
*
Yes
No
Please list the name, gender and age of ALL expected occupants including yourself. For example: Lisa, Female, 42, Kenny, Male, 12
*
Your answer
Are you currently employed?
*
Yes
No
Name and phone number of current employer.
Your answer
How long have you been with your current employer?
Your answer
What is your
total
monthly
income? Please include income for ALL household members (wages, disability, social security, etc)
*
Your answer
Have you or any occupant listed in this application ever been evicted, asked to move out or moved out of a home before the end of the lease term without the owner's consent?
*
Yes
No
If you answered yes above, please give explanation.
Your answer
Have you or any occupant listed in this application ever declared bankruptcy?
*
Yes
No
If you answered yes above, please give explanation.
Your answer
Have you or any occupant listed in this application ever been sued for rent?
*
Yes
No
If you answered yes above, please give explanation.
Your answer
Have you or any occupant listed in this application ever been sued for property damage?
*
Yes
No
If you answered yes above, please give explanation.
Your answer
Have you or any occupant listed in this application ever been convicted (or received an alternative form of adjudication equivalent to a conviction) of a felony, misdemeanor involving a controlled substance, violence to another person, sex crime, or destruction of property?
*
Yes
No
If you answered yes above, please give explanation including nature of the crime and year convicted.
Your answer
What is something you would like us to know about your family or your individual situation?
*
Your answer
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