Gray and Company Real Estate

 

     Please fill this out in its entirety and email it back to us. IMPORTANT! When filling in information, use your tab key or cursor to advance to the next field. If you hit "enter" it will prematurely submit the form before it's completed.

YOU MUST FILL OUT EVERY ITEM ON THE APPLICATION OTHERWISE IT WILL NOT BE CONSIDERED! Make sure you put in the property you are applying for.

     We should be able to qualify your application within 24-48 hours if all the other applicants have submitted their applications.

CONSUMER NOTICE

THIS IS NOT A CONTRACT

(licensee) Gray and Company Real Estate hereby states that with respect to this property, as described below_________________________, I am acting in the following capacity: (check one)

ð               (i)   owner/landlord of the property

ð               (ii)  a direct employee of the owner/landlord; or

ð               (iii) an agent of the owner/landlord pursuant to a property management or exclusive leasing agreement.

          I acknowledge that I have received this notice:

          (consumer signature)__________________________________(date)_____________________

           I certify that I have provided this notice:      (licensee)___________________________________________(date)____________________

YOU MUST FILL OUT EVERY ITEM ON THE APPLICATION OTHERWISE IT WILL NOT BE CONSIDERED! Make sure you put in the property you are applying for.

Please list the property you are interested in and the names of the people who will be renting there.


Please provide your present contact information:

Name
Street Address
Address (cont.)
City
State
Zip Code
Cell Phone
School Phone
E-mail

Please provide your parent's name and address:

Name
Street Address
Address (cont.)
City
State
Zip Code
Work Phone
Home Phone
E-mail

What is your current year in school?

What is your QPA?

Date of birth:

Please list your extra curricular activities, hobbies and interests:


Have you ever rented?

Please provide your landlord's name or Resident Assistant's name

Name
 Telephone

Please provide a character reference from school:

Name
Department
Work Phone

Please provide a character reference from home (that is unrelated to you):

Name
Street Address
Address (cont.)
City
State
Zip Code
Home Phone

Please provide the name of a person who will always know where I am (other than parents listed above or who you are rooming with):

Name
Street Address
Address (cont.)
City
State
Zip Code 
Home Phone

Please list references to assist us in checking your credit history. (Banks, loans, credit cards, etc.)


list the bank's name if you hold a checking account.


list the bank's name if you hold a savings account.


Indicate who will be paying the rent:

YOU MUST FILL OUT EVERY ITEM ON THE APPLICATION OTHERWISE IT WILL NOT BE APPROVED OR CONSIDERED IN A TIMELY MANNER! Make sure you put in the property you are applying for.

I hereby authorize those references listed above to disclose any and all credit information to Gray and Company Real Estate.check here

type your name here to indicate that you understand the consumer notice and that you authorize the credit check.

Hit Counter last updated 05/20/08  Fair Housing and Equal Opportunity

Gray and Company Real Estate is an equal opportunity housing agent
Copyright © 1999 [Gray and Company Real Estate]. All rights reserved.
Revised: May 20, 2008
 

    The Pennsylvania Real Estate Commission, Section 608 of the Act, requires that licensees provide consumers with the Consumer Notice at the initial interview.

      Before we can enter into a substantive discussion about your real estate needs you will need to sign a consumer notice which explains your rights as a consumer.  You can obtain the consumer notice at the Pennsylvania Real Estate Commission's web site:  http://www.dos.state.pa.us/bpoa/recommconsnotice.htm or click here to download the Consumer Notice.

     Gray and Company Real Estate, 203 Main Street, Brookville, PA  15825 USA, a licensed Pennsylvania broker.  You may call toll free 1-877-562-1020 or call locally at (814) 849-4199.    Fair Housing and Equal Opportunity