PALMYRA ESTATES. Application Checklist
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1 PALMYRA ESTATES Application Checklist Owner/Seller (Circle): Buyer/Renter (Circle): Address: Close/Move-in Date: Items to be returned to Quality Management: [ ] Forms: [ ] Application [ ] References [ ] Community Regulations Authorization for Background Review: (Associated Credit/ACR) [ ] Authorization Form [ ] Credit Application [ ] Payment(s): [ ] Buyer/Renter: [ ] $ (husband & wife) Application Fee: Ck# * Important: $50.00 for each additional person over 18 yrs of age. [ ] Security Deposit: (1) one equivalent to month s rent $ Security Deposit: Ck# [ ] owner [ ] renter [ ] Capital Contribution: $1,500 on all sales. Ck# [ ] Buyer [ ] Sales Contract or Lease (IF LEASE: Term= From To ) [ ] Homeowner s Association/Community Disclosure (For sale only) [ ] Maintenance paid in full (Attach Tops statement) [ ] All Open Violations must be completed prior to lease or sale RETURN TO: Quality Management Group, Inc La Fontana Blvd., Suite 101 Boca Raton, FL [ ] Report from ACR: [ ] Credit [ ] Criminal [ ] Public Records *******************************FOR QMG & BOD ONLY******************************* Description By Date [ ] Update Customer [ ] Application Complete [ ] To BOD for approval [ ] Approval letter sent o Sales price: o Rent (per/mo): Approval: YES NO [ ] Management [ ] HOA BOD
2 PALMYRA ESTATES RENTAL INSTRUCTIONS Approval of all rentals is contingent to agreement by the homeowner and tenant to the following terms and conditions: 1. Rentals by corporations, company, partnership or trust are not allowed. Single family use only. 2. Rentals shall not be for less than 12 months and are subject to review every year. 3. Renewals or extensions of leases are subject to re-approval by the Board of Directors. Lease renewals will be subject to an additional fee. 4. An application for rental must be submitted to the Association through the management company for background check and approval at least 30 days prior to date of occupancy. 5. A security deposit in the amount of one month s rent is required to be deposited with the Association. This is in addition to any security deposit that the homeowner may wish to have for his own benefit. The security deposit is subject to the following: a. Any damage by the lessee, their children, guest or visitors will be deducted form the security deposit b. The security deposit is refundable when the renter vacates the property, however, the Association in its sole discretion may retain all or any part of the funds: 1. as a non-exclusive remedy for any costs that it may incur in repairing any damage to property arising from the leasehold, 2. to cover any assessments for violations related to hold-over tenants (more than one year). c. Security deposits are non-interest bearing. 6. A copy of the Rental Contract or lease must accompany the application. 7. The following fees must be attached to the application: a. A non-refundable application fee check payable to the Palmyra Estates HOA must be attached to the application in the amount of $ b. A security deposit check for one month s rent 8. Applications will be rejected if the property has any open violations or if there any assessment or fine arrearages. 9. All applicants, occupants and/or guests are required to abide by the Association Documents, Rules and Regulations. Homeowners are responsible for the actions of their lessees, occupants and/or guests for any damage within the community and for any violations. It is the homeowner s responsibility to provide copies of the Association documents to the Applicant(s). 10. Incomplete applications will be returned as required. Agreed and Acknowledged Homeowner Name Print Date Tenant Name Print Date
3 PALMYRA ESTATES Application Form Please type or print clearly Date: Applicant s Name Spouse: Present Address City State Zip Phone Owner s Name Spouse Address City State Zip Phone Address of house Desired Date of Occupancy Names of people who will occupy house: (if additional use the back of this page) Name Relationship DOB Name Relationship DOB Name Relationship DOB How long have you lived at your present address? Contact: Type of Residence? P.H. Apt. Condo Co-op Other Employed by Employment References Phone Address City State Zip How long? Position Yearly Income Spouse Employed by Phone Address City State Zip How long? Position Yearly Income Insurance: Automobile Homeowners/Liability
4 PALMYRA ESTATES Screening Form Please list below every person who will be permanent occupant of You must provide all of the required information. You must also provide independent photographic evidence (such as driver s license or current passport) for each permanent occupant of the unit. 1. Occupant Name Age Type of Photographic Evidence Date of Birth Relationship to Occupant Please list all vehicles that will be parked in the community or on the driveway on a regular basis Make Model Truck Van Signatures of Applicant(s): Signature Print Name Date Signature Print Name Date
5 PALMYRA ESTATES References Form Bank References A) Bank Acct # Chg or Svgs Address City State Zip How long? B) Bank Acct # Chg or Svgs Address City State Zip How long? Character References 1) Name Res Phone Bus Phone Address City State Zip 2) Name Res Phone Bus Phone Address City State Zip 3) Name Res Phone Bus Phone Address City State Zip Previous Rental Reference: Name: Address: Telephone: Position: Cell Phone
6 Palmyra Estates Community Rules & Regulations 1. Parking: There shall be no parking on any portion of the sidewalk, grass or street within the Property. No commercial vehicle displaying any exterior signs, campers, mobile homes, oversized trucks, boats, row boat, canoe, house trailers, boat trailers or trailers of any description shall be parked and stored unless stored within garage. 2. Garbage and Trash Containers: All trash, garbage, and other waste shall be kept in trash/garbage cans, and except during pickup, if required to be placed at the curb, all containers shall be concealed from the public view. 3. Animals: No animals, livestock or poultry of any kind whatsoever shall be raised, bred, or kept on any lots, except that up to two household pets in total (and not of each type) consisting of dogs, cats or other household pets, provided they are not kept, bred or maintained for any commercial purposes. Furthermore no household pet shall be allowed to constitute a nuisance and each Owner shall promptly remove and dispose of waste matter deposited by his or her household pet through a proper sewage receptacle. The Board of Directors shall have the right to promulgate Rules further restricting the keeping of household pets. Effective May 8, 2012: Under no circumstances are Akitas, Pit Bulls, or any dog with Akita or Pit Bull Terrier in their background or pedigree, or any dog deemed a Dangerous Dog by any government agency, allowed to visit or be kept on any Lot or anywhere on the Property. Any dog affected by this rule owned by a homeowner or approved lessee prior to this rule's adoption by the Board of Directors on May 8, 2012 shall be permitted ("grandfathered in") until the dog dies or until the approved lease expires, if the property is leased. Homeowners of any dog Grandfathered in are required to register their pet with the Association's management company and provide evidence of current rabies vaccination and a photograph of the pet. 4. Garages: All garages must have doors that are maintained in useful, working conditions and no garage may be improved for purposes of making same a living area. 5. Signs: No sign of any kind shall be displayed to the public view on any lot, except one sign of not more than two and one-half square feet of advertising that property is for sale or rent. 6. Maintenance of Shrubbery and Landscape: It is the responsibility of the Association to cut the grass and trim the shrubbery. As well as maintain the irrigation.
7 7. Clothes Drying Areas: No garments, rugs or any other materials may be hung, exposed or dusted from the windows or from the front façade of any home. No outside clotheslines or other facilities for drying or airing clothes shall be erected in the front yard, side yard or back yard of any home. be used as a drying or hanging area of laundry, except that is screened from public view. 8. Air Conditioners: No window or wall air-conditioning units shall be permitted. 9. Nuisances: Nothing shall be done, permitted to be done, maintained or failed to be done to materially annoy or disturb anyone in the free use, possession, or enjoyment of his or her property and render it s ordinary use or occupation physically uncomfortable. 10. Screening: The ARB must approve of all plans for outside screening prior to construction. 11. Fences: Any request for fencing will require an ARB Application to be submitted to the Architectural Committee for approval. 12. Mailboxes: All mailboxes shall be uniform in type, color and design. All owners must install the standard approved mailbox and maintain in excellent condition. 13. House Colors: Shall remain as original colors selected for the Community. ARB Application is required. 14. Pavilion Rental: An Application along with a $75 refundable deposit is required. 15. Pool Rules: For the safety and well being of all residents, please follow all pool rules. 16. Basketball Hoops: Shall be professionally manufactured basketball backboards installed on black poles with white or clear backboard. No roof, building or roof mounted backboards are permitted. No portable basketball backboards may be kept outside of home overnight. No basketball backboard shall cause a nuisance. 18. No Trailers or Temporary Buildings: No tents, trailers, basement, shack, barn, shed or other out-building shall be used on any lot either temporary or permanent. Signatures of Applicant(s): Agreed: Date: Print: Thank-you and please enjoy the cleanliness and safety of our community. Your Board of Directors
8 Associated Credit Reporting, Inc West McNab Road, First Floor, Tamarac, Florida ***AUTHORIZATION FORM*** I/We hereby authorize Associated Credit Reporting, Inc. to obtain data to verify any and all information they request with regards to my/our Application for Occupancy, specifically the verification of my bank account(s), credit history, residential history, criminal record history, employment verification and character references. I/We hereby waive any privileges I/we may have with respect to the said information in reference to its release to the aforesaid party. Information obtained for this report is to be released to the authorized party designated on the Application for Occupancy, for their exclusive use only. PLEASE INCLUDE COPY OF DRIVER S LICENSE TO CONFIRM IDENTITY. If you do not have a driver s license, please include a copy of your Passport or current government issued identification card. I/We acknowledge our rights as stated in the Fair Credit Report Act that I/we are entitled to a copy of the report upon proper written request and can dispute any inaccurate information for re-verification. I/We understand that Associated Credit Reporting, Inc. is not directly involved in the approval or denial of any applicant. The information received by Associated Credit Reporting, Inc. shall be held in strict confidence, protected as governed under the Fair Credit Reporting Act, and will never be released to any third party other than the designated recipient. I/We further understand that this is a non-refundable process. By signing below, I/We further state the Application for Occupancy and Authorization Form were signed by me/us and was not originated with fraudulent intent by me/us or any other person and that the signature(s) below are my/our own proper legal signature. I/We certify (or declare) under penalty of perjury that I/We agree to the foregoing and; that all answers and information contained on the Application for Occupancy are true and correct and will hold Associated Credit Reporting, Inc. harmless from the result of the investigation. (Applicant s Signature) (Spouse s Signature) (Applicant s Name Printed) (Spouse s Name Printed) (Date Signed) (Date Signed)
9 PLEASE USE BLACK INK *** THIS APPLICATION IS FOR A SINGLE PERSON OR A MARRIED COUPLE ONLY! *** APPLICATION FOR OCCUPANCY Association Name: PALMYRA ESTATES HOA NOTE: All information supplied is subject to verification. All telephone numbers must be able to be reached between 9-5 P.M. Purchase Lease Occupant Apt.# Bldg.# Address applied for: Full Name Date of Birth Social Security # Single Married Separated Divorced How Long? Other legal or maiden name Have you ever been convicted of a crime? Date (s) County/State Convicted in Charge (s) Spouse Date of Birth Social Security # Maiden Name Have you ever been convicted of a crime? Date (s) County/State Convicted in Charge (s) No. of people who will occupy unit Adults (over age 18) Description of Pets Names and ages of others who will occupy unit Applicants Cell Number(s) Applicants Address In case of emergency notify Address Phone PART I RESIDENCE HISTORY A. Present address Phone (Include unit/apt number, city, state and zip code) Apt. or Condo Name Phone Dates of Residency: From to Own Home Parent/Family Member Rented Home Rented Apt Other Rent/Mtg Amount Name of Landlord Address Phone Mortgage Holder Mortgage No. Phone B. Previous address (Include unit/apt number, city, state and zip code) Apt. or Condo Name Phone Dates of Residency: From to Own Home Parent/Family Member Rented Home Rented Apt Other Rent/Mtg Amount Name of Landlord Address Phone Mortgage Holder Mortgage No. Phone C. Previous address (Include unit/apt number, city, state and zip code) Apt. or Condo Name Phone Dates of Residency: From to Own Home Parent/Family Member Rented Home Rented Apt Other Rent/Mtg Amount Name of Landlord Address Phone Mortgage Holder Mortgage No. Phone
10 PART II EMPLOYMENT REFERENCES *Include a recent copy of an earnings statement to expedite processing* A. Employed by Phone Dates of Employment: From: To: Position Fax Monthly Gross Income Address B. Spouse Employed by Phone Dates of Employment: From: To: Position Fax Monthly Gross Income Address PART III BANK REFERENCES *Include a recent copy of a bank statement to expedite processing* A. Bank Name Checking Acct. # Phone Address Fax B. Bank Name Savings Acct. # Phone Address Fax PART IV CHARACTER REFERENCES (No Family Members) *Please notify Character References that we will be contacting them to obtain a reference* 1. Name Home Phone Address Business Phone Address Cellular 2. Name Home Phone Address Business Phone Address Cellular 3. Name Home Phone Address Business Phone Address Cellular Driver s License Number (Primary Applicant). State Issued Driver s License Number (Secondary Applicant) State Issued Make Type Year License Plate No. Make Type Year License Plate No. If this application is not legible or is not completely and accurately filled out, Associated Credit (and the Association) will not be liable or responsible for any inaccurate information in the investigation and related report (to the Association) caused by such omissions or illegibility. By signing the applicant recognizes that the Association and Associated Credit will investigate the information supplied by the applicant, and a full disclosure of pertinent facts will be made to the Association. The investigation may be made of the applicant s character, general reputation, personal characteristics, credit standing, police arrest record and mode of living as applicable. This form is for the exclusive use of Associated Credit Reporting, Inc. Applicant s Signature Date Spouse s Signature Date
11 REMINDER INCLUDE COPY OF PICTURE ID FOR EACH APPLICANT
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