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Rockwood Gardens Online Rental Application

This application will not be considered unless filled out completely. All Security deposits are non-refundable unless Rockwood Gardens, at it's sole description, rejects this application.

Note: applying using our Online Rental Application starts the process in motion. You must also:

  • Fill it out completely
  • Sign it
  • Provide a copy of a Drivers License
  • Provide a copy of a Social Security Card
  • Send it to us

Each applicant 18 years or older must fill out their own application.

What floor level?

When needed?

# of Bedrooms 1 2

Pet?

Type of Pet


Applicant #1 (full name)
Social Security #
Date of Birth
Marital Status
Current Address
City
State
Zip
Telephone #
Current Landlord
Telephone #
How Long at Current Address?
Rent Amount $ /mo
Reason for Moving?
Previous Address
City
State
Zip
How Long?
Previous Landlord
Telephone #
Employer
Personnel Telephone #
Employer's Address
Zip
Position Held
How Long?
Annual Income from Employment $
Additional Income $
Describe Source of Additional Income
Phone # if Applicable
Credit References
Name/Address of Bank
Zip
Credit Cards Held
Make and Year of Car
License Plate #
Driver's License #
Registration #
Copy of License
Copy of Social Security Card
In Case of Emergency, Contact:
Name
Relationship
Tel#
Address
City
State
Zip
Emergency Contact #2:
Name
Tel #
Please List All Other Persons Who Will Reside in this Apartment:
Name
Relationship
D/O/B
Name
Relationship
D/O/B
Name
Relationship
D/O/B

Note: Having persons living in the apartment other than those listed would be a breach of lease and may result in eviction.

This does not represent an offer to lease an apartment, but is an application only. Nothing will be binding on either party unless, and until a Lease is fully executed by both the Landlord and Tenants (s).

I hereby authorize the persons listed above to release to the Landlord any information contained in this application, in order to process this application.

I hereby warrant that all my representations set forth above are true. I further represent that I am not renting another residence under any other name, nor have I ever been dispossessed from any apartment, nor am I now being dispossessed.

* No Pets Allowed *
Other than cats within certain restrictions. See Landlord's agent for details.

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Rockwood Gardens Apartments
51 Rockwood Circle - Rental Office, Apt. 20A
Middletown, NY 10941

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