General Information

Applicant Information

Present Address



Fill names of all individuals (and ages of all children) who will occupy premises other than you:




Other Income

Emergency Contact

IMPORTANT CERTIFICATION: (All deposits and fees paid with this application are non-refundable)

I certify that the above information is true, accurate, and complete. Ancora Properties is authorized to verify this information by contacting any or all individuals, financial institutions, and other contacts as provided herein including a credit profile check, criminal and general background check, rental history (eviction) check, and other investigations that may be necessary. I understand that this is not a lease and that no binding obligation of any kind exists between the owner and/or Ancora Properties and myself unless and until a lease is properly executed. I understand that Ancora Properties will incur costs in processing this information and that the application fee is not refundable.

IMPORTANT: Typing your name below is the same as signing this document

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