LEASE APPLICATION Location __________________ Unit _______________ Rent ____________

Applicant #1 (first name, middle, & last) ________________________________________________________________

Social Security __________________ Birth date ______________________________

Address (present) _________________________________________________ City/State _______________ Zip ______

Phone # ___________________ How long at this address? ______________________

Previous Address (if less than 1 year) ___________________________________________________________________

Employment ____________________________________________________________ Phone ________________________

Address ____________________________________________________________ City/State ________________________

Years/Months _________________ Position ________________________________________ Salary _________________

Previous Employer (if less than 1 year) __________________________________________________________________

Present Landlord ________________________________ Phone ____________________

Address _____________________________________________________________ City/State ________________________

Applicant #2 (first name, middle, & last) __________________________________________________________________

Social Security _______________________ Birth date __________________________

Address (present) ________________________________________________ City/State ____________________ Zip ____

Phone # ______________________ How long at this address? ____________________

Previous Address (if less than 1 year) _____________________________________________________________________

Employment ________________________________________________________________ Phone ______________________

Address __________________________________________________________________ City/State ____________________

Years/Months ____________________ Position ______________________________________________ Salary __________

Previous Employer (if less than 1 year) ____________________________________________________________________

Present Landlord _______________________________ Phone ______________________

Address ________________________________________________________________ City/State ________________________

Total number of people residing in apartment: ______ which include _________ Adults and

Children: Boys ______ Ages ________ Girls _____ Ages ________

By signing this application, you are giving the personnel of NWIAPTS LLC permission to proceed with a credit inquiry. By signing, you are also stating that all of the information on this application is correct.

Applicant #1__________________________________________ Date ________

Applicant #2__________________________________________ Date ________

Park Place and Meridian Apartments   5990 Old Porter Road   Apt 207   Portage Indiana   219-762-6555