Keeton Hanks Properties, LLC

P.O. Box 74
Auburn, KY 42206
Phone: 270-847-7664
Fax: 270-542-6893

PERSONAL INFORMATION
Name of Applicant: ___________________________________________

Gender: ______________

Current Address: _____________________________________________________________________

City: _______________________________

State: _________________

Zip: _________________

Phone (Work/Home): ________________________________

(Cell) __________________________

Social Security Number: ______________________________

Date of Birth: ___________________

Drivers License Number: _____________________________

State Issued: ___________________

Email: ______________________________________________________________________________
School Attending, if applicable: __________________________________________________________
Please list ALL prospective occupants, including children, to reside in your apartment.
Name: _______________________________ Age: _________ Relationship: __________________
Name: _______________________________ Age: _________ Relationship: __________________
Name: _______________________________ Age: _________ Relationship: __________________

EMPLOYMENT INFORMATION
Present Employer: ____________________________ Address: ______________________________
City: ____________________ State: _________ Zip: ___________ Phone: _________________
Length of Employment: ________________________ Position: ______________________________
Monthly Income: ______________________________ Take Home Pay: _______________________

RENTAL HISTORY
Current Landlord: ____________________________________ Phone: ________________________
How Long? ___________________________________

Monthly Rent: ________________________

Reason for Leaving: ___________________________________________________________________

Previous Landlord: ___________________________________ Phone: ________________________
Previous Address: _____________________________________________________________________
City: _____________________________ State: __________________ Zip: ___________________
How Long? ____________________________________ Monthly Rent: ________________________
Reason for Leaving: ___________________________________________________________________

EMERGENCY CONTACT INFORMATION

Name: ___________________________________________ Relationship: _____________________
Address: ____________________________________________________________________________
City: _____________________________ State: _________________ Zip: ____________________
Phone: ___________________________
Name: ___________________________________________ Relationship: _____________________
Address: ____________________________________________________________________________
City: _____________________________ State: _________________ Zip: ____________________
Phone: ___________________________

BANK INFORMATION
Bank Name: _________________________________________________________________________
Checking Account Number: ___________________ Savings Account Number: __________________
Other Income Not Listed: ____________________________ Source: __________________________

VEHICLE INFORMATION
Please list ALL prospective vehicles to be parked on property. Maximum two vehicles per unit.
Make: _____________________________________ Model: _________________________________
Color: _____________________ Year: ___________ License: _______________________

Make: _____________________________________ Model: _________________________________

Color: _____________________ Year: ___________ License: _______________________

BACKGROUND INFORMATION
Have you ever been convicted; plead guilty; plead no contest; received probation, deferred
adjudication, court-ordered community supervision or pre-trial diversion for a felony (whether or not
resulting in a conviction)? If yes, please explain.
_____________________________________________________________________________________
_____________________________________________________________________________________
Have you ever been convicted; plead guilty; plead no contest; received probation, deferred
adjudication, court-ordered community supervision or pre-trial diversion for a misdemeanor involving
violence or sexual misconduct (whether or not resulting in conviction)? If yes, please explain.
_____________________________________________________________________________________
_____________________________________________________________________________________
Have you ever been evicted or asked to move out from a previous landlord? _____________________
Do you currently owe any outstanding balance (s) to a previous landlord? _______________________
Do you currently owe any past due balance(s) to a utility company? ____________________________
Would you be capable of transferring all necessary utilities into your name immediately? __________
Have you ever broken a lease agreement? _________________________________________________
Do you smoke? If so, would you be smoking indoors? ________________________________________
When are you looking to move in? ________________________________________________________
Would you be capable of transferring all necessary utilities into your name immediately? __________
How long are you planning to reside in the apartment? _______________________________________

I certify all of the above information is true and complete. I acknowledge that false information herein
may constitute grounds for rejection for this Application, termination of right of occupancy and nonreturn of fees and deposits.
I hereby authorize Owner to use reasonable and necessary means, including any consumer reporting
agency, current and previous employer, current and former landlord, law enforcement agency, any
check authorization agency, and state employment security agency, to release all information any of
them may have about me and my Guarantor. I hereby release all of these parties, including but not
limited to the Owner and any agency designated by Owner, from any liability in connection with release
of such information. I hereby authorize Owner to obtain and hereby instruct any consumer reporting
agency designated by Owner to furnish a consumer report under The Fair Credit Reporting Act to Owner
to use such consumer report in attempting to collect any amounts due and owing under the Housing
Contract or the Guaranty of Resident Obligations or for any other permissible purpose.

Signature: ___________________________________________________ Date: __________________

Printed Name: _______________________________________________

GENERAL POLICIES & RESTRICTIONS

One year minimum lease. No pets, fish aquariums, or animals of any kind allowed. No smoking indoors.
No unnecessary loud noises. No outside storage. No signs, banners, flags, or stickers without prior
approval. No painting, cutting, or drilling to modify unit. No fastening to walls allowed including screws,
nails, or tape. No vehicles allowed on grass. No sub-leasing or unauthorized residents. Outdoor
furniture is limited and must remain aesthetically pleasing. Children must have adult supervision at all
times on premises. Utilities must remain active at all times. All late payments have a 10% penalty.

Completed applications can be returned to Keeton Hanks Properties, LLC by any of the following;
(a) Email: [email protected]
(b) Fax: 270-542-6893
(c) Mail: Keeton Hanks Properties, LLC
P.O. Box 74
Auburn, KY 42206