Previous/ 2nd Employer __________________________________

          Occupation ______________________________________________

          Employer Telephone (      )______-__________

          Address ________________________________________________

          Income _______ per ________

          Start date ___/___/___  End date___/___/___

          Additional sources of income: __________________________________________________________

          Name                          Address                                  Telephone

          ____________________ _____________________________________               

          (____)____-_________

          _____________________ _____________________________________                  

          (____)____-_________

          _____________________ _____________________________________               

          (____)_____-________

          1. Current Address ______________________________________ Apartment #____

          City, State, Zip__________________________________________County________

          Building Owner or Manager __________________________________

          Telephone (____)_____-__________

          Rented From ___/___/___ to ___/___/___  Rent Per Month___________

          Roommate Name _________________ Lease In the Name Of ________________________

          2. Previous Address _____________________________________Apartment # _____

          City, State, Zip__________________________________________County_________

          Building Owner or Manager ______________________________________

          Telephone (____)____-_________

          Rented From ____/____/____ to ___/___/___  Rent Per Month___________

          Roommate Name ___________________ Lease In The Name Of _______________________

          3. Previous Address ____________________________________ Apartment #______

          City, State, Zip_________________________________________County__________

          Building Owner or Manager _________________________________

          Telephone (____)____-________

          Rented From ____/____/____ to ____/____/____  Rent Per Month___________

          Roommate Name ___________________Lease In The Name Of ________________________

          Why are you moving from your current residence? ____________________________________

          ___________________________________________________________________________

          Bank __________________________________________ Checking ____ Savings _____

          Do you own a car? _________ Make _____________ Model __________ Color __________

          License Plate _______________ State ______

          Please list all persons who will be living in the apartment with you including children.

          Name Age Relationship

          ________________________________________________________________________

          ________________________________________________________________________

          ________________________________________________________________________

          Do you have any pets? ______________ What Kind? ____________________________

          Emergency Contact ___________________ Relationship _________________________

          Address ___________________________ Telephone _________________________

          Please tell us how you heard about our rental properties. __________________________

          ________________________________________________________________________

Please list on a separate sheet of paper any other information which you feel may affect the acceptance of this application.  This application form is intended for use in evaluation your qualifications for rental from Copenhagen Enterprises.  False or misleading statements during the interview and/or on this form are grounds for terminating the application process, or if discovered after commencement of residency, for initiation of eviction proceedings. 

The foregoing information is supplied to management to induce them to rent to me and is true and correct in all respects.  I authorize whatever credit and personal investigation you may consider appropriate.  This may include the exchange of information and a report from a credit reporting agency.  If a credit reporting agency furnishes a report, it's name and address will be supplied upon request. 

I am not now renting a room or apartment under any other name nor have I ever rented a room or apartment under any other name.  I have never been evicted from any apartment nor am I now being evicted. 

The undersigned represents that the statements on this application are true and complete and authorizes management to conduct whatever credit and personal investigations it may deem necessary.

          Date _________ Applicant Signature ______________________________________