University Park Application

UNIVERSITY PARK APARTMENTS
KIMBALL REAL ESTATE
87 Uptown Road
Ithaca, NY 14850

Applicant Name: _______________________________ SSN: ___________________

Current Address: _______________________________ Date of Birth:____________

_______________________________ Phone #_________________

Email Address: _______________________________ Cell Phone #_____________

Present Mortgage/Landlord: _________________________________________
Landlord Phone:___________________

Amount of Rent/Mortgage: $_________ Lease Expiration Date: __________________
Do you have a current NYSEG Account? (Y/N)_____________
If no are you eligible? (Y/N)___________

Current Employer: _______________________________________________________
Annual Income: $__________ Work Telephone #______________________________

If a student, or your major source of income is parent or guardian, please supply the following information:
Parent/Guardian Name:____________________________________________________
                           Address: _________________________________________________
                           Phone:     ___________ Email _________________________________
Will parent/guardian guarantee rent payment? Yes __   No __

Bank Information:
Name: _______________________________ Type of Account: _______________

Name: _______________________________ Type of Account: _______________

Spouse/other occupants:
Name:_________________________ Name: ________________________________
_______________________________________________________________________

I give permission to Kimball Real Estate/University Park Apartments to perform a credit/criminal check in connection with this Application.

Signature _________________________________ Date: _______________________
________________________________________________________________________

How did you hear about our apartments? ____________________________________