Community Application Form - Heritage Homes & Realty

1 Units Available

Email: [email protected]
Phone:608-783-7544

Location
3000 Spruce St, Holmen, WI 54636-9460

Heritage Village Application Form

Pets: 1 dog (20lbs. or less) or 2 indoor cats

"*" indicates required fields

Applicant Information

Each adult, including adult children, must complete a separate application.

Name*

First Middle Last

Email*

Phone*

Current Address*

Street Address Address Line 2 City State ZIP Code

Time At Current Address

Birthdate*

Marital Status

Married

Divorced

Separated

Unmarried

Current Home Type

Home Owner

Renter

Other

Employment

Employer Information

Add present and past employer information below. Start with current employer

Employer Name

Gross Pay/Month

Years Employed

Position

Address

City/State

Phone

Other Income

Other IncomeYou do not have to reveal information about alimony, child support or separate maintenance incomes unless you want to have them considered as a basis for qualification of residence. If you wish to have such income considered, please list source and monthly amount.

Amount

Source

Do you have a co-applicant:

Co-Applicant Information (optional)

Name

First Middle Last

Home Phone

Address

Street Address Address Line 2 City State ZIP Code

Time At Current Address

Birthdate

Marital Status

Married

Divorced

Separated

Unmarried

Current Home Type

Home Owner

Renter

Other

Co-Applicant Employment

Co-Applicant Employer Information

Add present and past employer information below. Start with current employer

Employer Name

Gross Pay/Month

Years Employed

Position

Address

City/State

Phone

Co-Applicant Other Income

Amount

Source

Other People

Information about additional people residing in your home.

Name

Relationship to Applicant

Data of Birth (MM/DD/YYY)

Additional Information

Vehicle Information

Make/Model

Color

Pet Type

Dog or Cat

Pet Name

Breed

Weight

Do you own a boat, trailer or other vehicle.

Yes

Please describe

The lease allows for two vehicles per homesite. Boats, campers, etc. must be stored outside the community or in a designated area.

Emergency Contact Person

Please list two contacts

Name

Relationship to Applicant

Address

Phone

Information About Your Manufactured Home Purchase

Existing Home in Our Community

Address

Street Address Address Line 2 City State ZIP Code

Purchase Price

History

1. Have you, or co-applicant if applicable, declared bankruptcy within the past 10 years? Who? Where? When?*

2. Have you, or co-applicant if applicable, had any judgements, repossessions, garnishments, or legal proceedings filed against you within the past 7 years?*

3. Have you, or co-applicant if applicable, ever obtained credit under any other name(s)? List name(s) used:*

4. Have you or any other proposed occupants of the site been convicted of a crime? If yes, explain*

5. Have you or any other proposed occupants of the site been evicted? If yes, explain.*

6. Have you or any other proposed occupant of the site ever been convicted of the illegal manufacture or distribution of a controlled substance? If yes, explain.*

7. Are you or any other proposed occupant of the site, a current illegal user or addict of a controlled substance? If yes, explain.*

8. Have your or any proposed occupant ever been convicted of a sex related crime or required to register as a sex offender? If yes, explain.*

Submit

For the purpose of obtaining the credit requested, I represent that the information provided above is true, complete and correct. I understand that if my application is approved, any false statements on or in connection with this application may result in eviction. You are hereby authorized to verify this information and obtain additional information concerning my credit, employment history or any other information, including without limitations, consumer credit reports, to furnish such information and any other credit experience with me to others, and to answer any questions about my credit experience and other financial relationships with you. If I am required to provide a security deposit, I understand that such deposit will be returned if my application is not approved. I have read, understand and agree to comply with the Rules and Regulations of the Community now in effect, including any future amendments or postings thereto. By submitting this Application, I acknowledge that I have been provided with the opportunity to review the Privacy Policy below and understand and accept the statements contained therein. I understand that I can request a hard copy of the Privacy Policy by contacting you at 250 Scott Dr, Onalaska, WI 54650.

Landlord reserves the right to deny tenancy if:
• You misrepresent information on this application, If misrepresentations are found later, your rental agreement may be terminated.
• Your background check includes drug, other criminal activity or prior evictions or unsatisfied judgements.
• Your credit check shows an unsatisfactory record.
• Any other lawful reason.

We collect nonpublic personal information about you from the following sources: 1) information we receive from you on your applications or other forms; 2) information about your transactions with us, our Affiliates, or others; and 3) information we receive from a consumer reporting agency. We do not disclose any nonpublic personal information about our residents or former residents to anyone except as permitted by law. We restrict access to nonpublic personal information about residents and former residents to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal standards to guard your nonpublic personal information. We will contact you via phone for your Social Security Number to complete this application. For security reasons we do not accept this information online.

I Agree

Application fee

Price:

Credit card fee

$0.00

Credit card fee

$0.00

Total

Credit Card

Card Details

Cardholder Name

Billing Address*

Associated with the credit card.

Street Address City State ZIP Code

1 Units Available

Heritage Village Application Form

Applicant Information

Employment

Co-Applicant Information (optional)

Co-Applicant Employment

Other People

Additional Information

Emergency Contact Person

Information About Your Manufactured Home Purchase

Existing Home in Our Community

History

Submit

Office Hours

Links of Interest