To Courtyards Village West Apartments, hereinafter called Owner and to PRAIRIE MANAGEMENT & DEVELOPMENT, INC., Agent for the Owner, the undersigned hereby apply(ies) for and offer(s) to execute a lease in form used by Owner for the premises herein described on the terms herein set forth.  The representations herein made are true.

1. Contact Information

2. Apartment Desired

3. Rental History

4. Apartment Occupants

5. Present Employment Information

6. Past Employment Information

7. Income


THE FIRST MONTH'S RENT AND THE SECURITY DEPOSIT ARE PAYABLE ON SIGNING OF LEASE. RENT IS PAYABLE ON FIRST DAY OF MONTH. In consideration of the investigation by said Agent of above representations and references, the undersigned hereby deposits with said agent the sum of $50.00_ to be disposed of as hereinafter provided. $50.00 is for credit report and not returnable. If the application is rejected by the Owner, the deposit will be returned to applicant. If applicant shall fail to sign a lease when submitted or fail to pay the balance of rental and security deposit as provided, then the security deposit shall be retained by the Owner’s Agent, as liquidated damages. Further, if any of the information provided herein proves to be false then the application shall be denied and any deposit shall be forfeited to Owner’s Agent as liquidated damages. The applicant acknowledges being furnished copies of the Residential Lease and Rules & Regulations for inspection. The Applicant agrees to sign the completed Lease and Rules & Regulations before taking occupancy of the premises. The landlord strongly encourages all Tenants to obtain renter’s insurance, said insurance may protect your assets in the event of fire and may protect you if you are sued for any reason.