Page 1 APPLICATION FOR LEASE

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Page 1 APPLICATION FOR LEASE WILLIAMSBURG PROPERTY MANAGEMENT, INC. 811 RICHMOND ROAD/WILLIAMSBURG, VA 23185 (757)229-8292 - PH (757)229-2943 - FAX E-MAIL: wpm@wpminconline.com The property will be shown and made available to all persons without regard to race, color, creed, religion, national origin, sex, familial status, handicap, or elderliness in compliance with all applicable federal and state and local fair housing laws and regulations. This Application for Lease, is made on,, between APPLICANT (whether one or more) (Date) and LANDLORD, through WILLIAMSBURG PROPERTY MANAGEMENT, INC. (who represents the Landlord). Applicant hereby applies for a residential living unit located at, Williamsburg, VA, (Address of property) for occupancy commencing on, and ending on, at an initial monthly (Date of move-in) monthly rent payment of $ Dollars. **PLEASE FILL IN ALL INFORMATION COMPLETELY; IF IT DOES NOT APPLY WRITE N/A FOR THAT ITEM** 1. Applicant 1: SSN: Date of Birth: Driver s License number or Gov. issued identification card number: State issued: Is Applicant a U. S. citizen? If NO, please provide a copy of Passport, Visa or Green card. Tel # (H): Tel # (W): Cell Phone #: Email: Present Address: City State Zip code Landlord/Property Mgmt Co. name: Rent amount: Dates occupied: Landlord s Tel #: ****COMPLETE PREVIOUS ADDRESS IF YOU HAVE BEEN AT CURRENT ADDRESS LESS THAN 3 YEARS.**** Previous Address: City State Zip code Landlord/Property Mgmt Co.name: Rent amount: Dates occupied: Landlord s Tel#: Presently Employed by: How Long?: (If self-employed or retired, please provide most recent 2 years tax returns.) Position: Salary: $ Supervisor: Telephone number of main/home office and/or Human Resource Dept.: Fax number of Human Resource Dept. if known: Are you a college student? Are you an Undergrad or Grad student?

**PLEASE FILL IN ALL INFORMATION COMPLETELY; IF IT DOES NOT APPLY WRITE N/A FOR THAT ITEM** Page 2 If starting a new job/second job, please list company name: Position: Salary: Telephone: Supervisor: Start date: Formerly Employed by: How long? Supervisor: 2. Applicant 2: SSN: Date of Birth: Driver s License number or Gov. issued I.D. card number: State issued: Is Applicant a U. S. citizen? If NO, please provide copy of Passport, Visa or Green Card. Tel # (H): Tel # (W): Cell Phone #: Email: Present Address: City State Zip code Landlord or Property Mgmt Co. name: Rent amount: Dates occupied: Landlord s Tel #: ****COMPLETE PREVIOUS ADDRESS IF YOU HAVE BEEN AT CURRENT ADDRESS LESS THAN 3 YEARS.**** Previous Address: City State Zip code Landlord/Property Mgmt. Co. name: Rent amount: Dates occupied: Landlord s Tel#: Presently Employed by: How Long?: (If self-employed or retired, please provide most recent 2 years tax returns.) Position: Salary: $ Supervisor: Telephone number of main/home office and/or Human Resource Dept.: Fax number of Human Resource Dept. if known: Are you a college student? Are you an Undergrad or Grad student? If starting a new/second job, please list company name: Position: Telephone: Salary: Supervisor: Start date: Formerly Employed by: How long? Supervisor: 3. Other Occupants/ Name: Age: Relationship: Children: Name: Age: Relationship: Name: Age: Relationship:. Name: Age: Relationship: Anyone age 18 and older must complete an application and pay $50 application fee.

**PLEASE FILL IN ALL INFORMATION COMPLETELY; IF IT DOES NOT APPLY WRITE N/A FOR THAT ITEM** Page 3 4. Pet 1: Kind: Type: Color: Weight: Name: ID Tag #: Male/Female: Age: yrs mths Spayed/Neutered: Other: Pet 2: Kind: Type: Color: Weight: Name: ID Tag #: Male/Female: Age: yrs mths Spayed/Neutered: Other: *IF COMPLETING NUMBER 4, PLEASE INCLUDE FOR EACH ANIMAL A PHOTO AND A CURRENT RABIES CERTIFICATE. 5. If you are presently in Armed Services, state: Applicant s Branch: Rank: Outfit: Telephone: Co-Applicant s Branch: Rank: Outfit: Telephone: 6. Other Income: Such as education loans, stocks, savings, retirement, child support, etc. Must be able to verify for it to be counted (i.e.: tax return, bank letter). Applicant: Amount: $ Per: Source of: Co-Applicant Amount: $ Per: Source of: AUTOMOBILE:MAKE - YEAR MODEL & COLOR FINANCED BY & ADDRESS MO. PAYMENT LICENSE PLATE #: AUTOMOBILE:MAKE - YEAR MODEL & COLOR FINANCED BY & ADDRESS MO. PAYMENT LICENSE PLATE #: 7. CIRCLE IF YOU OWN: CAMPER MOTORCYCLE BOAT TRUCK TRAILER 8. In Case of Emergency Notify: Name Address Phone Relationship 9. Do you smoke? Yes or No 10. A non-refundable application fee in the amount of $50 per applicant ($80 per married couple) payable by MONEY ORDER OR CASHIER S CHECK (NO CASH OR PERSONAL CHECKS ACCEPTED). Security deposit and pet deposit (if applicable) is due at the time of application approval (no later than close of next business day). A mailing fee of $25 shall be charged to applicant if Lease papers need to be mailed for signing. Note: If making an offer application fee is still non-refundable. *If application is rejected, Deposit will be refunded by check in ALL applicants names unless other arrangements have been made.

**PLEASE FILL IN ALL INFORMATION COMPLETELY; IF IT DOES NOT APPLY WRITE N/A FOR THAT ITEM** Page 4 11. Upon signing of this Application, and approval of the Applicant(s) to be become Tenant(s) in this living unit, Agent will remove the said unit from the available for rent list. Applicant(s) agree to pay Landlords actual expenses and damages up to the full amount of the deposit should the Applicant(s) fail to execute a Lease Agreement and begin paying rent specified in this Application for occupancy of the premises. Agent reserves the right to make all appropriate deductions from the deposit to recover the Landlords actual damages and expenses as allowed by applicable Virginia law. 12. DISCLOSURE OF BROKERAGE RELATIONSHIP: Landlord and Applicant confirm that in connection with the transaction contemplated by this Application, the Listing/Leasing Broker and its salespersons represent Landlord. 13. RENTAL AND CREDIT HISTORY: a.) Reason for leaving current residence: b.) Has any Applicant ever been rejected for tenancy? Yes No. If yes, please explain: c.) Has any Applicant ever refused to pay rent when due, been a defendant in an unlawful detainer action or eviction, or otherwise been sued by a landlord for matters related to a tenancy? Yes No. If so, please give details, and the status of any pending actions: d.) Has any Applicant ever filed for bankruptcy? Yes No. If yes, please give dates of filing and status of case: 14. CRIMINAL HISTORY: Has any Applicant ever been convicted of, pleaded guilty to or entered a plea of no contest to any felony, or to any misdemeanor involving a crime of moral turpitude in any jurisdiction? Yes No. If the answer is yes, please give all details, including the specific offense (s), dates(s), sentence(s) and jurisdiction(s) in which the offenses occurred, as well as any information on the status of any current probation. 15. Applicant(s) should exercise whatever due diligence Applicant deems necessary with respect to information on any sexual offenders registered under Chapter 23 (sec. 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 or www.vsp.state.va.us/.

Page 5 The Applicant(s) hereby certifies that the information contained in the Application for Lease is true and correct to the best of Applicant s knowledge and belief. Applicant(s) hereby authorizes Listing Broker to conduct a credit check on Applicant(s) and an appropriate background check (ie.: employment/salary/rental history) to verify information provided herein by Applicant(s) for approval or rejection of this Application. We have read the terms and conditions of this Application for Lease. We understand this is a binding contract separate and apart from the Lease Agreement. SIGNATURE OF APPLICANT DATE SIGNATURE OF APPLICANT DATE PLEASE ATTACH COPY OF A PICTURED ID OF EACH APPLICANT IF NOT PRESENT WHEN SUBMITTING APPLICATION TO WILLIAMSBURG PROPERTY MANAGEMENT, INC. LISTING BROKER TO VERIFY APPLICANT S IDENTIFICATION

Page 6 DO NOT COMPLETE THIS PAGE The following to be completed by WPM, INC: The undersigned acknowledges receipt from Applicant of the sum of $ by money order or cashier s check payable to WILLIAMSBURG PROPERTY MANAGEMENT, INC., which amount consists of an application fee in the amount of $ and a security deposit in the amount of $. Signature of Recipient Date/Time Received This Application for Lease is hereby ACCEPTED as of day of,. Signature of Agent

RESIDENT SELECTION CRITERIA INTRODUCTION: Residents are to be impartially selected in accordance with applicable Federal and State laws. Williamsburg Property Management, Inc. reserves the right to reject anyone that may jeopardize the future stability of the property. To be eligible for occupancy, applicants must meet the following selection criteria: 1. Applicant(s) must be 18 years of age or older to qualify. 2. A $50 per person ($80 per married couple) non-refundable application fee must accompany the application, payable by cashier s check or money order-no CASH-NO PERSONAL CHECKS. We also reserve the right to require a higher security deposit. 3. Applicant(s) must present a photo ID and original social security card with application. Persons without social security cards, or non-u.s. citizens, must provide an acceptable form of ID as follows: a. Form I-551 Permanent Resident Card (Green Card) b. Form I-94 Arrival/Departure Record, Form I-94W (green paper) c. Work Visa (B-1, B-2, F-1, H-1B, etc.) We will not accept Personal Taxpayer ID or the Matricular Consular Card. The taxpayer ID is simply issued by the IRS for the purpose of filing a tax return and is issued regardless of immigration status. The only purpose of the Matricular Consular Card is to show that the bearer is a Mexican national living outside of Mexico. 4. Applicant(s) must be currently employed. Employment will be verified for the previous 6 (six) months. Exceptions will be made for full time college students. 5. Household income will be verified. Gross income must be three times the monthly rental rate to qualify. Additional income sources (child support, retirement benefits, social security, etc.) requires written proof in the form of tax documentation or bank statements. (If all income cannot be verified, an applicant is not eligible for occupancy). 6. Applicant s credit history must be good. Applicants will be denied if any of the following appear on the credit report: a. A bankruptcy that has not been discharged. b. Judgments for rent or evictions. 7. Applicant s previous rental history is considered. Documentation from previous Landlord concerning applicant s noncompliance with lease, rental payments, rules and regulations, or unsanitary housekeeping, will result in the applicant being rejected. Termination or nonrenewal of lease by current or previous Landlord or apartment community will result in rejection of the application. 8. Co-signers will be accepted for college students. Co-signers must meet all the requirements as stated above and must have income that equals at least 6 (six) times the monthly rent. (If not a student, Landlord will have final say whether to consider a co-signer/guarantor). 9. Should Landlord allow a pet, there will be a pet deposit. Pet Deposit amount is set by Landlord (usually a minimum of $300 but, can vary). Deposit is refundable if no damage. NO Pit Bulls, Rottweilers, Chow Chows or any mixes of these dogs are allowed. 10. Should false information be furnished on the rental application, the application will be automatically rejected and security deposit returned. I have read and understand the Resident Selection Criteria. Signature Signature Date Date