Application – Westside Apartments Please contact management for any questions regarding eligibility. To qualify for our housing, you must fill out the application below, or call to schedule an appointment. Westside 1 & 2 bedroom units in Stayton, OR. Contact us at (503) 979-0009 or email@example.com Property Name you are applying for*We want to confirm. See property name above. Applicant Name*Applicant Email* Applicant Phone*Alternative NumberYour Address* Street Address City State / Province / Region ZIP / Postal Code Preference Bedroom Units* 1BD 2BD 3BD Others Household Composition*NameAgeRelation to head of houseDate of birthM/FSocial security # (Conditional) Click + sign for adding more membersDo you anticipate any changes to your household size in the next 12 months?* yes no If you answered YES (Explain)Rental History (prior 3 years)Current Address* Street Address City State / Province / Region ZIP / Postal Code Move In Date* Move Out Date* Landlord Name*Landlord Phone #*Monthly Rent*Previous Address Street Address City State / Province / Region ZIP / Postal Code Move In Date Move Out Date Landlord NameLandlord Phone #Monthly RentLeast Previous Address Street Address City State / Province / Region ZIP / Postal Code Move In Date Move Out Date Landlord NameLandlord Phone #Monthly RentUnit Size Required 1-3 Persons | 1 Bedroom 2-5 Persons | 2 Bedrooms 4-7 Persons | 3 Bedrooms 8-9 Persons | 4 Bedrooms What is your housing situation? Homeless Recovering from Abuse Living w/another family Recovering from Domestic Violence Living in a Labor Camp Paying HIGH Rent Total Income of all Household Members:SOURCES OF INCOME INCULDE BUT NOT LIMITED TO: Welfare, Social Security, SSI, Pension, Disability, Compensation, Unemployment, Interest, Child Care, Caretaking, Alimony, Child Support, Annuities Dividends, Income from Real Property, Armed Forces Reserves, Scholarships and/or Grants, Wages form odd jobs including seasonal jobs.click + for more columns*NameWages/SalaryOther Sources/temporary jobs$$$ Annual X$$$ Monthly XNo. of Months on the jobName of Employer Total Income from above table*1. Have you or any member of your household previously rented from Evolve Property Management? yes no If yes, please indicate the month/year2. Have you or any member of your household ever been evicted?* yes no If yes, please explain.3. Do you or a member of your household require a Handicap unit? yes no If yes, what features or auxiliary aids do you require5. Have you or any person who will occupy the unit ever been convicted, plead guilty, no-contest or have current pending charges to any felony or misdemeanor?* yes no 6. Are you or any person who will occupy the unit a registered sex offender?* yes no If Yes, Date and location of registration:7. Do you have Assets such as: Checking/Savings Account, including Real Property, Stocks, Bond.* No ( assets in or outside of US ) Yes ( I do have assets Exceeding $5,000) Please list the value of the total amount of assets*8. Do you or a member of your household require a disability adjustment to your income? No Yes (Disability must be verified) Number of DependentsIS Head of household or spouse 62 or over?* Yes No If yes, do you receive social security benefits? No Yes $$$9. DO you or a member of your household require a childcare adjustment to your income? No Yes (Must be Verified) Number of DependentsIf yes, please indicate the amount? $Applicant Name*Date* Agent for OwnerDate The information regarding race, ethnicity, and sex designation solicited on this application is requested in order to assure the Federal Government, acting through the Rural Housing Service that the Federal Laws prohibiting discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial status, age, and disability are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the race, ethnicity, and sex of individual applicants on the basis of visual observation or surname.Ethnicity Hispanic or Latino Not Hispanic or Latino Race American Indian/Alaska Native Asian Black or African American Native Hawaiian or Other Pacific islander White Gender Male Female This iframe contains the logic required to handle AJAX powered Gravity Forms.