JAMES R. WILLIAMS TOWER

CHECK WHICH BEDROOM SIZE YOU NEED: *

1 STANDARD BEDROOM UNIT

1 HANDICAP BEDROOM UNIT

Head of Household Name: *

First Name

Last Name

Date Of Birth: *

MM

DD

YYYY

Choose Proof of Identification: *

Driver's License

State I.D.

Other

Current Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone: *

(###)

###

####

Home Phone:

(###)

###

####

Work Phone:

(###)

###

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Are you currently living in subsidized housing? *

YES

NO

VOUCHER

Are you required to give a 30-day vacancy notice? *

YES

NO

Are you a full-time student? *

YES

NO

CO-HEAD OF HOUSEHOLD:

First Name

Last Name

Date Of Birth:

MM

DD

YYYY

Choose Proof of Identification:

Driver's License

State I.D.

Other

Current Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone:

(###)

###

####

Home Phone:

(###)

###

####

Work Phone:

(###)

###

####

Are you currently living in subsidized housing?

YES

NO

VOUCHER

Are you required to give a 30-day vacancy notice?

YES

NO

Are you a full-time student?

YES

NO

THE ONLY TYPE OF RENT OPTION: *

I am applying for the Income Based (subsidized) program.

I/WE UNDERSTAND THAT WILLIAMS TOWER, LLC WILL PERFORM BOTH A CREDIT CHECK AND/OR CRIMINAL BACKGROUND CHECK. I/WE UNDERSTAND THAT MY APPLICATION FOR HOUSING MAY BE DENIED BASED ON THE FINDINGS. *

CONFIRM