Residential Properties Application

Thank you for your interest in leasing with Rose Company. Please provide all of the information requested below so that your application can be processed quickly. If you prefer to download and print your application to complete by hand, you may download it here.

Download the Residential Lease Application

Property Information

Property: * This field is required

Unit #: * This field is required

Property Address:

Street:

City:

State:

Zip:

Application Information

Full Name: (First, MIddle, Last) * This field is required

Date of Birth (mm/dd/yyy) *

This field is required

Home Phone: * This field is required

Cell Phone: * This field is required

Email: * A valid email address is required

Current Address:

This field is required

Street: * This field is required

City: * This field is required

State: * This field is required

Zip: * This field is required

Do you own or rent this property? *

Own

Rent

This field is required

Monthly payment or rent: * This field is required

How long? * This field is required

Name of Landlord:

Landlord Phone:

Landlord Fax:

Previous Address:

Street:

City:

State:

Zip:

Did you own or rent this property?

Own

Rent

Monthly Payment or Rent?

How long?

Landlord Name:

Landlord Phone:

Landlord Fax:

Employment

Current Employer: * This field is required

Employer Address:

This field is required

Employer Address: * This field is required

City: * This field is required

State: * This field is required

Zip: * This field is required

How long? * This field is required

Position: * This field is required

Is your income:

Hourly

Salary

Annual income: *

This field is required

Phone: *

This field is required

Email: * A valid email address is required

Fax:

Previous Employer:

Employer Address:

City:

State:

Zip:

How Long:

Phone:

Email:

Fax:

Vehicle Information

Auto Make:

Plate #:

Year:

Model:

Color:

Additional Information

Number of intended occupants: * This field is required

Names of intended occupants:

Have you ever been sued, Garnished, Evicted or filed Bankruptcy: *

Yes

This field is required

Have you or any person who will reside with you ever been convicted of a felony? *

Yes

This field is required

If yes, please provide date, nature of offense, sentence and dates of incarceration:

Have you or any person who will reside with you in the apartment ever been convicted of or plead guilty to a “sexually -oriented Offense” or been required to register with a designated law enforcement official pursuant to Ohio Revised Code 2950.01 ET. Seq.? *

Yes

This field is required

When would you be ready to move? *

This field is required

Pet Information

Do you have any pets? *

Yes

This field is required

Kind of Pet:

Breed:

Weight:

Age:

Kind of Pet:

Breed:

Weight:

Age:

Veterinarian Name:

Veterinarian Phone:

Emergency Contact

Name of a Person Not Residing with You:

Emergency Contact Address:

Street:

City:

State:

Zip:

Telephone:

Relationship:

References

Name: * This field is required

Street: * This field is required

City: * This field is required

State: * This field is required

Zip: * This field is required

Phone: * This field is required

Relationship to Applicant: * This field is required

Name: * This field is required

Street: * This field is required

City: * This field is required

State: * This field is required

Zip: * This field is required

Phone: * This field is required

Relationship to Applicant: * This field is required

Authorization for Release of Information

I have read this application and certify that the information in this application is complete and accurate. I also agree that this application will become part of the Lease Agreement entered into with Rose Company. I authorize Rose Company to obtain all such information as may be required concerning all of the statements made in this application. In addition, I am authorizing the release of information to obtain and verify my employment, criminal, credit history, rental and residence history. I further authorize landlord, its agents and/or attorneys to obtain credit reports and information any time during and after my tenancy, in the event of a breach of any lease or term of tenancy. I hereby release all sources, their officers, agents and employe es from liability of any nature, whether caused by negligence or otherwise, which may result from the answering of questions concerning my past record.

I have read the above statement and authorize release of information. *
This field is required

Smoke-Free Facility. Tenant agrees and acknowledges that the premises to be occupied by Tenant and employees has been designated as a smoke-free environment. Tenant and employees shall not smoke anywhere in the premises leased by the Tenant, or the building where the Tenant's premises is located or in any of the common areas.

Please fill out this application in its entirety. Missing information will delay the processing of this application.
Residential Applicants will be charged a $30.00 Non-Refundable Application Processing Fee. Please make check payable to: Rose Company

Rose Company
4015 Medina Road, Ste. 200
Medina, Ohio 44256

Phone: 330.725.6767