1. Date of Birth

VILLAGE REALTY APPLICATION410 Orchard Court, Red Lion, PA 17356

Phone: 717-246-1111 Fax: 717-246-9877

Please return one month's current pay stubs & security deposit with completed application.Applicant agrees to $50.00 application processing fee should applicant withdraw application.

Applicant's full legal name , apply to leaseas of attherentof$-permonth,foraperiodofoneyear.

Sex Marital Status S. S. #

2. Names of other occupantsDoyouhaveapet?-HowmanyPets?Whatkindofpet?

3. Vehicle: Make Color Dr. Lic. #

4. Current Residence:

Plate #

DatesresidedFrom:To:-Rentpaid$-permonth.Name of Landlord Phone #

5. Previous Residence:DatesresidedFrom:To:-Rentpaid$-permonth.Name of Landlord Phone #

6. Have you ever been evicted or asked to move out? Declared bankruptcy?Broken a rental agreement or lease contract?

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Been sued for non-payment of rent?

7. Name of Emplover or Business Phone:Net income per week Dates employed From: _ To:Circle: full-time or part-time position? Permanent or through a Temp Service?

8. Do you have a police record? Charges Parole StatusHave you ever been convicted of a felony? Please indicate the yearType of felony Location of felony

9. Emergency Contacts: (one parent & another relative or friend)NameRelationship

Name

AddressPhone #

AddressPhone #Relationship

Applicant herebv verifies that the statements above are true. correct and complete and authorizesverification of all references listed above and to obtain credit reports.

Cell# Home#Signature of applicant Date

I have read and initialed Paragraphs A, B, C, D, E, F, G, H,I, J, K

Rec'd.$ CK# for Date _ by

We are an equal housing opportunity provider. We provide rental housing without discrimination on the basis of race,color, religion, sex, physical or mental handicap, familial statuso national origin or other protected classes. Revised 4/14

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RULES AND REGULATIONS

PETS. No dogs, cats, animals or pets will visit or be kept in or outside the leased premises. AnyResident or guest found keeping a dog, cat, animal or pet temporaniy or peffnanently withoutwritten agreement with Owner, in or outside the premises, agrees that it is a violation of the leaseand will be charged a fee of $100.00 per animal per day from the date the animal is discovereduntil it is removed from the premises. If the dog, cat, animal or pet is not removed from the leasedpremises and fee paid within five (5) days from the date the Owner discovers the animal, theOwner will file for eviction through the cour1.

KEYS. Two door keys are provided for each residence. Resident will return all keys to theOwner at the end of the lease, or Resident will be charged for the keys and cost of changing thelocks, $50.00 per door. There is a $75.00 per dav holdover charge for any keys that are notreturned by midnight on the last day of the terminating month. Should Resident require entry tothe premises as a result of lost or misplaced keys during office hours, Resident may borrow a keyfrom the office or pay Owner a selice charge of $40.00 at the time of service to unlock the door.All other times, Resident will need to contact a locksmith. Resident may NOT change doorlocks, contact Owner if you need a lock change.

NOISE. Residents, their family, visitors, and guests will not at any time make any noise, orconduct themselves in any way that disturbs other Residents or interferes with the otherResident's rights, comforl or convenience. Courtesy hours are in effect 24 hours a day at alltimes. Music, televisions, instruments and noise will be kept at a quiet level inside and outsidethe apartment between 10:00 p.m. and 8:00 a.m. Resident agrees that it is a violation of thelease if they fail to comply with this rule.

LEASE BUY-OUT. Resident has the option to buy-out the remaining term of the first year'slease by paying Owner an amount equal to three (3) months rent. After Resident gives Owner therequired 60-day written notice from the first of the month, Resident may buy out of the lease.

PLUMBING. Resident shall not put wipes of any kind (hygiene. cleaning, baby wipes).rags. sweepings" sanitary napkins" tampons. ashes or any other improDer items into theplumbing fixtures. Resident is responsible for plumbing costs if plumber opens sewer lines andremoves any foreign objects. DO NOT USE SANITIZING TOILET BOWL OR TANKTABLETS & CLEANERS (i.e. Clorox tablets, 1000 flushes) as any resulting damage shall be atResident's expense. If plumbing becomes clogged or stopped up after (1) month of occupancy,cost of opening the line will be paid by Resident. Only human waste, toilet paper and watertrelong in toilets. Resident must advise Owner of any and all leaks, constantly running toilet orany other plumbing malfunction which may cause the water usage to be excessively high. Failurebv Resident to advise Owner immediately of any problem will result in Resident being heldresponsible for the excessive water and sewer bills.

GRILLS AND SPACE HEATERS. Kerosene, electric space heaters, grills, charcoal, lighterfluid, gas cans and gas or propane bottles are not permitted in or on leased premises, basement,gatage, patio, deck, sheds or anyrvhere on the property. Electric grills will be permitted providingwhen in use they are a minimum of 15 feet from the building and or an1'thing combustible. Wemust insist that no bottled gas" kerosene. space heaters. grills. charcoal. lighter fluid. gascans and gas or propane bottles be used or stored on the premises.

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(G) SNOW REMOVAL. Resident is responsible for own snow and ice removal of personal porches,steps, walks and private driveways. Owner is responsible for snow and ice removal for allcommonly shared steps and walks. Owner will maintain all parking lots and cart ways.Individual parking areas, which cannot be easily maintained by Owner, will be Residentsresponsibility.

VEHICLES. A11 vehicles on the premises must have a cunent registration, current inspectionand be operable. A1l others will be towed away at Resident's expense. On-site car maintenanceand repairs are prohibited. Motorcycles must be kept in parking lot or garage, not inside theleased property or on the patio or porch. Resident is permitted maximum of two licensedvehicles on Owner's property (residences with two-car gara,ge excluded). If Resident owns morethan two vehicles, Resident must park them elsewhere. No electric, gas or battery-operatedchildren's vehicles permitted. Unregistered, non-working or disabled vehicles, boats, motorhomes, campers, tractor-trailers and their cabs are prohibited from being in parking lots at anytime.

USE OF NAILS AND SCREWS. Resident shall not drive nails into doors, woodwork orceiling of said premises. Resident will use only standard picture hangers or small nails in thewalls for hanging pictures, mirrors and the like. Damage resulting from excessive fastners is notconsidered normal wear and tear. Use of adhesive, double stick tape or stick-on hangers isstrictlv prohibited.

RENTER'S INSURANCE. Resident must obtain renter's insurance, with a minimumpersonal liability of $250.000.00. Resident must provide written proof of such insurance,prepaid for one year, prior to moving into the redsidence. Resident is required to maintainsuch renter's insurance throughout the term of the lease. Owner is not responsible for lossor damage to personal propefty due to theft, water, fire or intemrption of water, electricor other utilities occurring.

ROOF AND WINDOWS. All windows must have proper window treatments within twoweeks from date the Resident takes possession. Sheets, towels, blankets, flags, etc. are notpermitted. No sign, advertising matter, roof aerial or other structure is allowed in any window orroof of the Owner's properly. No awning is allowed in or at any window of the property unlessResident first gains written permission from the Owner.

PERSONAL PROPERTY. Resident will keep all personal property including children's toysinside the residence. Resident agrees to keep the exterior and interior of apartment in a neat andclean condition. Cigarette butts are not to be in the yard or mulch, Resident is permitted anoutdoor ashtray for extinguishing cigarettes which must be emptied regularly. Only furnituredesigned for outdoor use is permitted on patios, balconies or decks.

WASHERS AND DRYERS. Where laundry rooms are provided, kindly remove clothespromptly so you will not inconvenience Residents that are waiting. Residents are not permitted touse their own washers and dryers in the leased premises unless the leased premise has Ownerinstalled plumbing and electric or gas for a washer and dryer.

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(N) WATERBEDS. Resident is responsible for all damages caused by the waterbed to theapartment or other sunounding apaftments. Resident must provide Owner with a copy of rentalinsurance policy indicating waterbed damage coverage.

SHOWERS. Resident will clean fiberglass showers and or tubs with a liquid detergent, NOT aharsh cleanser.

VINYL & TILE FLOORS. Resident will use only a mild detergent and cleaners specified forvinyl and tile floors. Do not use wax, ammonia or varnish on any floor. Damages shall be atResidents expense.

LIGHT BULBS. Resident must fuinish their own replacement light bulbs, both inside lights andoutside porch lights, fluorescent bulbs and appliance bulbs. Resident may not remove bulbs whenvacating property.

GARBAGE. Where dumpsters are provided, individual garbage cans are not permitted. Put alltrash in tightly closed plastic bags and deposit them in the dumpsters provided. Do not placegarbage bags on porches, patios or in the shrubbery beds. Trash must remain inside the propertyuntil the morning of curb side collection or taken directly to the dumpsters where applicable.

ADDITIONAL EQUIPMENT. Resident agrees not to install any additional equipment such assatellite dishes, air conditioners, deep freezers, or heating units without Owner's written consentand proper installation. Resident is responsible for damage due to additional equipment.

ALTERATIONS. Resident will not paint, wallpaper, perform electrical changes or otheralterations. Resident agrees not to make any structural changes or alterations, additions ordecorations to the leased premises without Owner's written consent. Resident agrees not toremove any existing structural components or existing fixtures without Owner's written consent.

TRANSFER POLICY. Residents may transfer from one property to another without giving therequired sixty (60) day notice to Owner. Resident will be charged a fee of ONE HLINDRED($100.00) DOLLARS if the transfer request occurs in the first year of the lease. Resident agreesto sign a new one (1) year lease commencing on the date of the transfer.

GUESTS. Guests of Resident who stay longer than seven (7) days are considered unauthorizedpermanent occupants. This is a violation of the lease and will be subject to a $25.00 per day perperson charge which shall be payable as additional rent. Owner must approve Resident'srequest to add an additional leaseholder or occupant. Resident is responsible for the guest'scompliance to rules and regulations.

CEILINGS. Resident shall advise Owner immediately of any new ceiling cracks or sagging.Resident may not put screws, nails or tacks in the ceiling.

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