At Geitgey Complexes Inc. we appreciate your online rental application.  We look
forward to contacting you by either phone or e-mail.  Rental rate must be no more
than 25% of monthly income.   Credit rating must be above average for all adults
in unit. No more than two single adults or one married couple per unit.  No more
than two people per bedroom. NO PETS.  Carriage Hill is an OVER-55 community.

Full Name: Birth Date:
Present Address: Soc. Sec. No.:
City: Phone:
State: Phone 2:
Zip Code: Marital Status:
How Long: Home:    Rent     Own     Other
Previous Address:
Present Landlords Name & Address:  
Employer Name & Address:  
How Long Employed:         Net Monthly Income:  
Previous Employer Name & Address:  
How Long Employed  (Previous Emp.) :  
Additional Monthy Income & Source:  

Co-Tenant or Spouses Name:           Soc. Sec.#:  
Co-Tenant or Spouses Birth Date:  
Co-Tenant Present Address:  
Co-Tenant or Spouses
Employer's Name & Address:
How Long Employed:         Net Monthly Income:  
Total # Persons to Occupy Premises:  
Number of Dependents:       Ages and Relation to You:  
List Makes, Year, Color and
License Numbers for all Vehicles
to be on Premises:

Total Balance Due Creditor Name Monthly Payment

Emergency Contact No. 1:  
Emergency Contact No. 2:  

Have you or your co-tenants ever been convicted of a crime:    Yes    No

How did you hear about us?

I hereby grant my consent to Geitgey Apartments for verification purposes, to contact with CBC Credit Services-Dayton, to provide a written credit report on the above information, which is accurate to the best of my knowledge.  I also swear that I am the person as stated on the application above being submitted.
E-Mail:   (Required)
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If you would like a copy of this application
e-mailed back to you, check this box.