Unfortunately, we no longer accept American Express

Lee Street Management's
Online - Apartment Application

 Online forms are much faster and easier.        
If you would like to make a formal application for an apartment,
complete this form and press the Submit button at the bottom of the page.
(Preferred)  Apartment Address:   Unit:  
First Name:   Middle:   Last :  
Social Security # :   Date of Birth:   E-mail address:  
Driver's License:   Maiden or Former Name, if any:  
Home Telephone:   Cell Phone:   Pager:

Present Street Address:   City:   State:   Zip:

Present Landlord:   Present Landlord's Telephone:  
Monthly Rent:     Dates at Current Address:      Move-in Date:     Lease-ending Date:  

Previous Street Address:   City:   State:   Zip:

Previous Landlord:   Previous Landlord's Telephone:    
Monthly Rent:  

Dates at Previous Address:     Move-in Date:     Move-out Date:  

Present Employer:   Type of Company:

Employer's address:   City:   State:   Zip:

Dates Employed:    From:     Current Status:  
Monthly Gross Income:   $ Other Income $: Supervisor:
Your Work Number:
Supervisor's Number:
Title and Brief Job Description:
Additional Comments, Instructions or
Information that may be helpful:
Nearest Relative: Phone: Relationship:
Reference Name: Phone: Relationship:
Reference Name: Phone: Relationship:
Have you ever had any involvement whatsoever, in a Landlord/Tenant Court action?
Yes
Not  Sure
No
If  "Yes" or  "Not Sure,"  please describe circumstances in detail, including Case Number, Dates, State and County, Parties, Judgments, Agreed Orders, or Resolutions, etc.:

Name(s) of others who will share apartment with you (including pets)
           

Car Make:  
Car Model: 		Year:  
Color: 
License Plate:
Issuing State:
We require a $25 application fee, in advance, before we can process this Online Apartment Application. You may send a check or money order under separate cover. If you choose to mail a check, it will delay the application process by several days. Note:  Beginning November 5, 2008, we will no longer accept online credit card payments.
Mail checks to: Lee Street Management, 7601 North Eastlake Terrace, Chicago, IL 60626. Make checks payable to: Lee Street Managemet.


Method of Payment for Application Fee:

         

Credit Card Number:
Month:


Year:
I understand and hereby authorize agent/owner and any consumer or credit reporting agency or bureau employed by it to investigate my character, general reputation, mode of living, credit and financial responsibility, ability to pay rent, and the information provided with this application, and to inquire and check with the persons and references named herein. This application shall become a part of any lease for this apartment. I agree to the terms of Lee Street Management's application and security deposit policy at http://www.leestreet.com /application/index.php as though fully set forth herein.  I saved a copy of that policy for my records in the event LSM changes the policy subsequent to the date of this application or that webpage becomes otherwise unavailable.

  You must check this box to indicate that you read and agree to the above, and that this is your signature below.


Signature: /s/   Date:  

If you have questions about how Lee Street Management may use
your personal information, please review our Privacy Policy.