February 21, 2022 admin Rental Application – Mercedes Avila Please complete the rental application below Mercedes AvilaReal Estate Brokermercedesavila18@gmail.comP: (773) 870-0690 / O: (847) 495-5000 HomeSmart Connect7240 W Devon Avenue Chicago, IL. 60631 Real Estate Broker's NameReal Estate Broker's PhoneReal Estate Broker's Email AddressProperty InformationStreet Address *Apartment, suite, etcCity *State/Province *Parking *ParkingNoYes, included in rent.Yes, not included in rent.Monthly Rent ($) *USDDesired Lease Start Date *mm/dd/yyyyDesired Lease End Date *mm/dd/yyyyAPPLICANT INFORMATIONPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle NameLast Name *Applicant's Social Security Number (SS#). Exp. 123-45-6789 *Social Security Number (###-##-####)0 / 11Applicant Birthday *mm/dd/yyyyApplicant's Email Address *Applicant's Phone *(###)###-#### or ###-###-####CURRENT ADDRESS INFORMATIONStreet Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweHow many months at current address? *How many months at current address? E.g. 11Monthly rent at current address *USDCurrent Landlord's Name *Landlord Phone *(###)###-#### or ###-###-####Landlord Email Address *Can we contact your landlord? *YesNoNot ApplicableComments0 / 90CURRENT EMPLOYMENT INFORMATIONAre you currently employed? *YesNoIf Yes, then must provide employer's contact info.Employer's Name *Provide employer's contact information if you are currently employed. Supervisor's Phone *(###)###-#### or ###-###-####Supervisor's Email Address *Additional sources of incomeComments0 / 90EMERGENCY CONTACT INFORMATIONEmergency Contact Name *Emergency Contact Phone *(###)###-#### or ###-###-####Emergency Contact Email Address *Street Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabwePET AND ADDITIONAL INFORMATIONDo you have pets? *NoYesDescribe your pets? *Cat, dog, ferret, aquarium fish, etc. If no pets, then state: "No Pets"0 / 90Are you applying jointly with other Applicants? *YesNoList all occupants who will be living in the property *List all applicants and all occupants who will be living in the property (First Name and Last Name). If you are the only applicant/occupant, then state: "Just me."0 / 90Upload Supporting DocumentationUpload the following: (a) copy of your Driver's License, State ID, or Passport; (b) 12 months of bank statements, on each monthly statement circle or highlight rent payments to your current landlord; and, (c) 2 most recent paystubs. Check each box on the right after uploading each document to confirm.To confirm, check each box for each file you uploaded to this Rental Application. *I uploaded a copy of my Driver's License, State ID, or Passport.I uploaded 12 months of bank statements, on each monthly statement I circled or highlighted the rent payment to my current landlord.I uploaded 2 most recent paystubs.I confirm that the total size of attachments is less than 25 MB, and that acceptable file types are: .pdf, .jpg, .jpeg, .jpe, .gif, .png, .bmp, .tiff, .tif, .psd. No scanner? Take a photo of the document in good lighting using your smartphone.All supporting documents must be uploaded. Incomplete Rental Application will not be considered.Upload files: (a) copy of your Driver's License, State ID, or Passport; (b) 12 months of bank statements, on each monthly statement circle or highlight rent payments to your current landlord; and (c) 2 most recent paystubs. *Drag and Drop (or) Choose FilesUpload the following: (a) copy of your Driver's License, State ID, or Passport; (b) 12 months of bank statements, on each monthly statement circle or highlight rent payments to your current landlord; and (c) 2 most recent paystubs. Check each box on the right after uploading documents to confirm. The total size of attachments must be less than 25 MB. Acceptable file types are: .pdf, .jpg, .jpeg, .jpe, .gif, .png, .bmp, .tiff, .tif, .psd. No scanner? Take a photo of the document in good lighting using your smartphone.Submit Payment to CompleteYour Rental Application will be submitted upon payment. Your debit card or credit card will be charged $49.99I agree to the Terms and Conditions *Yes, I agree with the Terms and Conditions.We do NOT store your personal information after processing.Your Tenant Screening will be processed upon payment.Checkout to Submit. Submit Application