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Sam’s Up North Properties

320-761-4931
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  • Cottage Creek Estates
  • The Keep at Pine Grove
  • Residents
  • Contact Us

Rental Application

"*" indicates required fields

Step 1 of 7

14%
A Separate Application Required for Each Applicant.
MM slash DD slash YYYY
Desired Lease Term

APPLICANT INFORMATION

Name (Full Legal Name)*
MM slash DD slash YYYY
Max. file size: 1 GB.

OCCUPANTS AND RELATIONSHIP TO APPLICANT

List
Name
Relationship
 

APPLICANT / OCCUPANT VEHICLE(S)

List
Make
Model
Year
 

EMPLOYMENT HISTORY

Address
MM slash DD slash YYYY
Still Employed?
MM slash DD slash YYYY

Address
MM slash DD slash YYYY
MM slash DD slash YYYY

RENTAL HISTORY

Current Address
Dates lived at this address:
MM slash DD slash YYYY
MM slash DD slash YYYY

Previous Address
Dates lived at this address:
MM slash DD slash YYYY
MM slash DD slash YYYY

INCOME

INCOME REQUIREMENTS: To be considered for residency at Cottage Creek Estates a minimum income of $1,500 is required.
INCOME REQUIREMENTS: To be considered for residency at The Keep at Pine Grove a minimum income of $3,200 is required.
Max. file size: 1 GB.

CREDIT & FINANCIAL INFORMATION

CREDIT CARDS

VEHICLE LOANS

OTHER CREDIT

MISCELLANEOUS INFORMATION

Do you have pets?
NOTE: Additional fees and/or deposits are required for pets housed on premises. In addition, specific rules and regulations regarding pets may apply. **One pet allowed per unit, under 40lbs
Do you smoke?
Do you plan to have water filled furniture on the rental property?
Have you ever been evicted?
Have you ever been convicted of a felony?
Have you ever filed for bankruptcy?

APPLICANT PERSONAL REFERENCES

Please provide 3 personal references.
Reference Name #1
Address

Reference Name #2
Address

Reference Name #3
Address

APPLICANT EMERGENCY CONTACT

Emergency Contact Name
Address
Consent*
I understand that if my application is approved, I am required to carry renter's insurance at my own expense and that a copy of the policy must be provided to management.
Consent*
I hereby certify and affirm that all information provided above is true and correct. I fully understand that my lease or rental agreement may be terminated if I have made any false, misleading or incomplete statements in this application. I hereby authorize verification of all information provided in this application, including financial and credit information , via a credit bureaus and/or contact with current and previous employers, current and previous landlords and personal references.
Clear Signature
MM slash DD slash YYYY

Sam's Up North Properties

  • Cottage Creek Estates
  • The Keep at Pine Grove
  • Residents
  • Contact Us
4538 Platt Dr NW, Bemidji, MN
320-761-4931
Mon-Fri 8:00AM - 3:00PM
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