Requested Rental Location:
Desired Dates of Stay:
(This is an approximation of how long you will be in the apartment. It does NOT serve as the required 14 day written notice to vacate.)
Number of Bedrooms Needed:
Quoted Rent Amount:
$



Corporate/Company Rental Application

A security deposit of $200.00 is required before move-in date and will be refunded to the Applicant if there is no outstanding balance remaining for
any reason regarding the rented apartment. Deposit will be forfeited if apartment lease/obligations are not fulfilled by Applicant. Any forfeiture of
deposit does not credit towards any balance owed. Applicant understands that by signing below they agree to be responsible for all collection fees in
the event of any default. Applicant understands that this deposit will hold the requested apartment and that the amount will be forfeited if
Applicant decides not to take the apartment and fails to give cancellation notice within 72 hours of submitting this application. Upon vacating, a
minimum charge of $100.00 will be deducted from deposit for housekeeping/redecorating fees.* INITIALS

I agree to provide Premier Living Services, Inc. a two week (14 day) written notice before vacating the rented apartment * INITIALS

Reference letter is required from accounting/HR department on company letterhead confirming rental expenses will be paid by company.
*
INITIALS


COMPANY INFORMATION

Company Name:*
Company Website:*
Fed. ID# *      Contact Name:
Street Address:
City:       State:      Zip:      Contact Phone:
Company Phone:      Fax:      Email:*
Human Resources Contact:      Phone Number:
Reason for stay: * Temp Need Relocating     Dunn & Bradstreet Number:


RESIDENT INFORMATION

Name:*      Phone:
SSN#      Mobile Phone:      
Present Street Address:
City:      State:      Zip:
Position:      Email:
Supervisor’s Name:      Supervisor’s phone:
Other Occupants that will reside in the unit:
Pets: yes no    How many: *      Type/Breed(s): *      Weight(s): *

If the pet is approved by Premier Living Suites, the following pet fees apply: For each pet 24 lbs. or under, there is a $200.00 non-refundable fee. For each pet 25 lbs. or more there is a $300.00 non-refundable fee. (Maximum of 2 pets per apartment).
*
INITIALS (NOTE: Initialing here does NOT imply you have a pet, only that you understand the pet policy enforced by Premier Living Services, Inc.  ALL pets are to be listed in written form PRIOR to arriving in the apartment.)


PAYMENT INFORMATION

*CREDIT CARD REQUIRED BUT DOES NOT HAVE TO USED AS FORM OF PAYMENT*
Deposit Payment :
Rent Payment :     

Name on Card:
Credit Card # (Visa/MC/Discover) *      3 or 4 digit security code: *      Exp. Date: *
Address where you receive the credit card statement: *
City: *      State: *      Zip: *

How did you hear about our service?    Do you need Premier Living Mortgage assistance? yes no

By selecting "yes, I agree" below, you acknowledge that the information provided in this application is true and correct to the best of your knowledge. Premier Living Services, Inc. is authorized to make any investigation in your personal, financial and/or credit history through any investigative or credit agencies or bureaus. You also authorize Premier Living Services, Inc. to charge the credit card above.

YES, I AGREE



Post Office Box 361383 • Birmingham, AL 35236 • Toll Free 800.987-8828 •Office 205.978-8885 • Fax 205.978-8892 • www.premierliving.com