Application for Residency | Sandpiper Resort Co-Op

Residency Information

Unit Number *

Residency From *

Residency To *

Monthly Unit Rent ($) *

Primary Applicant

Full Name *

Date of Birth *

Social Security Number *

Monthly Income

Email *

Maiden Name

Add Spouse / Co-Applicant

Co-Applicant Full Name

Date of Birth

Social Security Number

Current Address

Street Address *

City *

State *

ZIP Code *

Phone *

Additional Occupants

List all persons desiring residency other than yourself and spouse (up to 3).

Vehicles

Vehicle 1 — Make & Year

Vehicle 2 — Make & Year

Criminal History

Have you ever been convicted of a felony? *

No Yes

Emergency Contact

Contact Name *

Daytime Phone *

Evening Phone

Relationship *

Address

Authorization & Release of Information

AUTHORIZATION OF RELEASE OF INFORMATION: Applicant(s) represents that all of the above information and statements on the application for rental are true and complete, and hereby authorizes an investigative consumer report including, but not limited to, residential history (rental or mortgage), employment history, criminal history records, court records and credit records. This application must be signed before it can be processed by management. Applicant acknowledges that false or omitted information herein may constitute grounds for rejection of this application, termination of right of occupancy, and/or forfeiture of fees or deposits and may constitute a criminal offense under the laws of this State.

I have read and agree to the above authorization

Application Fee

Non-refundable application fee of $25 per person.

Total Fee: $25.00

Applicant Signature *

Sign below using your finger or mouse.

Sign Here

Clear

Co-Applicant Signature

Sign Here

Clear

Driver's License Photo *

Upload a photo or take a picture of your driver's license.

Tap to upload or take photo

JPG or PNG, max 10MB

Co-Applicant Driver's License

Tap to upload or take photo

✓

Application Submitted!

Your Application for Residency has been received and will be reviewed by management. You will be contacted regarding the status of your application.

Reference Number:

Application Fee:

Please make check payable to Sandpiper Resort Co-Op.

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