Application For Residency












































































































FC Representation. Resident hereby represents that neither Resident nor any person who resided or is proposed to reside with Resident in the Community is or will be a Prohibited Person,as that term is hereinafter defined. A "Prohibited Person" is any entity, person or party: (i) that is listed in the Annex to, or is otherwise subject to Executive Order 13224 issued on September 24, 2001 ("EO13224"); (ii) whose name appears on the United States Treasury Department's Office of Foreign Asset's current list of "Specifically Designated National and Blocked Persons" (which list may be published from time to time in various mediums including, but not limited to website, http://www.tres.gov/ofac/t11sdn.pdf) (the OFAC list); (iii) who commits, threatens to commit or supports "terrorism", as that term is defined in EO13224; or is affliated with any entity or person above.

Pursuant to the State and Federal Fair Credit Reporting Acts, this is to inform you that an investigation involving the statements made on your rental application to the aforementioned community as well as inquiries regarding public records, your character, general reputation, personal characteristics and mode of living may be initiated. You may dispute the information reported. Upon written request, you are entitled to a complete and accurate disclosure of the investigation's nature and scope as well as written reports and remedies under the Fair Credit Reporting Act. Inquiries should be directed to Resident Data, Inc., PO Box 850454, Richardson, Texas 75085-0454. We certify with your knowledge and authorize Resident Data, Inc. to obtain all reports and verifications necessary to verify all information put forth in the above application and to release information to the landlord named above.



Applicant Signature

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Spouse Or Occupant Signature

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