Rental Property Applied For: Street:
City:
Date Application Turned in:
Date Wanting to Take Occupancy:
Name:
Spouse:
Current Address: Street:
City:
State:
Zip:
Move-in Date (month/year):
provide former city/state:
Ph #:
Email:
SSN (Required):
Do you own or rent your current residence:
OwnRentOther
Explain:
If you do not rent your current residence, do you have rental experience:
YesNo
Do You Have PetsYesNo

Type & Size of Pet(s)*:

* If the Landlord allows pets, most pet friendly properties require a $300 refundable pet deposit and $25 additional monthly rent per pet.
Present Landlord / Management Company:
Monthly Payment:
Ph #:
Email:
Reason for Leaving:
Previous Landlord:
Monthly Payment:
Address: Street:
City:
State:
Zip:
Ph #:
Email:
Move-in Date (month/year):
Move-Out Date (month/year):
Reason for Leaving:
Present Employer:
Position:
Address: Street:
City:
State:
Zip:
Ph #:
Email:
Supervisor/HR Dept. email:
Salary:
Length of Employment:
Former Employer:
Position:
Address: Street:
City:
State:
Zip:
Ph #:
Email:
Supervisor/HR Dept. email:
Salary:
Length of Employment:
Credit References:

Have you ever filed for bankruptcy or had a foreclosure?
YesNo
If yes please explain below:
List Other Income Sources:

Other Persons That Would Occupy the Unit

Name:
Age:
Relationship:
Name:
Age:
Relationship:
Name:
Age:
Relationship:
Name:
Age:
Relationship:
Driver's License #:
Type of Vehicle Make & Model:
License Plate #:
Financed by:
Monthly Payment:
Monthly Payment:

If You Are Presently In the Armed Services Please Complete:

Rank:
Serial Number:

Emergency Contact:

Name:
Ph #:
Address:
Relationship:

NOTICE TO APPLICANTS

Applicant(s) should exercise whatever due diligence applicant(s) deems necessary with respect to information on any sexual offenders registered under Chapter 23 (19.2-387 et seq.) of Title 19. Such information may be obtained by contacting your local police department or the Department of State Police, Central Records Exchange at (804) 674- 2000.

DISCRIMINATION

Landlord and Agent do not discriminate against Tenant(s) in the provision of services, or in any other manner, on the basis of race, color, religion, sex, national origin, familial status, age or handicap.

AGENCY DISCLOSURE

Applicant understands that in connection with the transaction contemplated by this application, AAPM Realty, LLC is the agent of the Landlord and is acting on behalf of the Landlord as the Landlord's listing and leasing agent.


By signing below, I acknowledge that I have applied for rental property with AAPM Realty, LLC thereby authorizing its staff to contact any and all references necessary to obtain information required for approval of this application.

I further acknowledge that I have read and understood this application

Applicant Signature:
Date:
Additional Applicant Signature:
Date:
AAPM REALTY, LLC

P.O. Box 2182 (Mailing)
165 Massanetta Springs Rd (Physical)
Harrisonburg, VA 22801
540-423-3879 | rentals@aapmrealty.com

AAPM Realty, LLC is a licensed real estate brokerage in the state of Virginia. It is also licensed by the State of Virginia to manage Community Associations.

Virginia law and regulations require real estate agents to disclose their agency relationships to all prospective customers and clients. In addition to meeting the requirement is intended to educate consumers about agency relationships and the duties of real estate agents, brokers, and firms. For convenience, this group is referred to as “licensees” since they are all required to be licensed by the Virginia Real Estate Board.

Agency is the relationship when one person works for or represents another person by express authority. People who licensees represent are called clients. People who receive services from licensees without being represented by the licensees are called customers. A licensee does not necessarily represent the person who pays him or her. As a result, a licensee can represent the buyer, be paid by the sellers, the Landlord, or vice versa. Although agency relationships can be formed without a written agreement, you should not assume that any person represents you unless you have a written agreement with them. The agreement between the licensee and the client creates a brokerage relationship.

Client status. As a client, you enter into an agreement with a licensee for that licensee to represent you. This agreement may be called a “listing”, a “management agreement”, a “lease agreement”, a “buyer broker agreement”, or an “agency agreement”, depending on whether you are a seller, landlord, buyer, or a tenant. You are then the licensee’s client. If the agreement is an exclusive agreement, you are required to work through that licensee. The licensee will generally be entitled to a commission if you buy, sell, or lease (as appropriate) property, even if you do not use the services of the licensee. The licensee is required to give you advice as to price and other matters and to disclose any material information known to the licensee about the property of the transaction. The licensee will also help you to negotiate favorable terms. The licensee is also required not to disclose to other parties any personal or financial information about you or any other information you ask to be kept confidential.

Customer status. As a customer, you do not sign an agreement with a licensee (although the licensee is still required to obtain a disclosure form). You are then the licensee’s customer. The licensee will represent the other party in the transaction, who will be the licensee’s client. You are legally required to work through the licensee, and the licensee will only be entitled to a commission if you buy, sell, or lease (as appropriate) property through the licensee. The licensee can give you general advice and is required to treat you honestly and disclose material facts known to the licensee regarding the physical condition of the property, but the licensee generally cannot give advice regarding price or assistance in negotiating favorable terms. The licensee is required to disclose to their client any information which it knows which may be helpful to the client. If you will be a customer, you should be aware that there may be other relevant information concerning the transaction which may be obtained from other sources.

Additional Duties of Licensees. In addition to the duties that are described above and any duties included in the agreement between the licensee and the client, licensees have certain duties under Virginia law and the Virginia Real Estate Board regulations. Licensees must promote the interest of their client by seeking a buyer or tenant or an appropriate property for their client, although they are not required to continue these efforts after a contract has been signed, and by timely presenting all written offers and counter-offers. Licensee must account to their clients for all money and property which the licensee receives in which the client has an interest. Licensee who represents buyers must disclose to a seller whether the buyer intends to occupy a property as their principal residence. Before a licensee inters into a brokerage relationship, the licensee must advise the prospective client of the type of relationship which is proposed, and the licensee’s compensation and whether the licensee will share that compensation with a licensees who presents another party to the transaction. Licensees owe their clients a duty of ordinary care.

Dual Agency. Dual Agency, or Dual Representation is when the same licensee represents both the buyer and the seller or the landlord and the tenant. This generally happens when a buyer or tenant who is a client of the licensee becomes interested in a property which is listed with the same real estate company. This lead to possible conflicts of interest, in which Virginia law permits licensees to handle in two different ways. The first alternative is Simple Dual Agency. With this alternative, the broker and all salespersons continue to represent both parties, but they don’t share any confidential information. The other alternative involves the use of Designated Representative. With this alternative, the broker is still a dual agent, but separate agents are name to represent the buyer and seller, or landlord and tenant, and these agents represent their respective clients as if the agents work for separate companies. Both agents give their best advice and keep the confidences of their clients. Licensees are required by law to disclose to both parties whenever a dual agency relationship arise and any time designated representative are used, and all parties must then sign a Disclosure of Dual Representation or Disclosure of Use of Designated Representatives form.

Firm policies. When representing sellers, landlords, and optionors, AAPM Realty, LLC, has a policy of cooperating with both licensees who work with the other party as customers, and licensees who work with the other party as clients, unless otherwise instructed by the Firm’s client. The Firm ____ will or ____ will not compensate licensees who do not represent the Firm’s client. When working with buyers, either as customers or clients, the Firm’s policy is to show properties listed with the Firm and other real estate firms. When working with buyers/tenants/optionees as customers, the Firm ____ will or ____ will not show properties being offered for sale by owner if the owner will enter into a listing agreement for that showing.

Fair Housing. It is illegal, pursuant to the Federal Fair Housing Law, 42 U.S.C.A. 3601, to refuse to sell, transfer, assign, rent, lease, sublease or finance housing accommodations, refuse to negotiate for the sale or rental of housing accommodations or otherwise deny or make unavailable housing accommodations because of race, color, religion, sex, familial status as defined in Section 4112.01 of the Revised Code, ancestry disability as defined in that section, or national origin or to so discriminate in advertising the sale or rental of housing, in the financing of housing, or in the provision of real estate brokerage services. It is also illegal, for profit, to induce or attempt to induce a person to sell or rent a dwelling by representations regarding the entry into the neighborhood of a person or persons belonging to one of the protected classes.