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For Application information, please call (270) 272-1222. An application must be completed and returned along with a $25 application fee per married couple or a $25 application fee per unmarried co-tenant(s) and written consent for a background and credit check accompanied by copies of current paystub(s) or other income verification.

Desired Location:
Desired # of Bedrooms:
How did you find out about us? Explain if other:
Number of Applicants: 1    2     3     4
Applicant 1: Applicant 1 SSN#:
Applicant 1 DOB: Applicant 1 Sex:
Applicant 2: Applicant 2 SSN#:
Applicant 2 DOB: Applicant 2 Sex:
Applicant 3: Applicant 3 SSN#:
Applicant 3 DOB: Applicant 3 Sex:
Applicant 4: Applicant 4 SSN#:
Applicant 4 DOB: Applicant 4 Sex:

Others Living In Household:  
Name Age Sex DOB SSN

Child Support:  
Are you entitled to receive child support?   Yes    No
Is the child support court ordered?   Yes    No
What amount do you receive from child support/alimony/etc? Per
Do you pay for child care to enable you to work? Yes  No   Amt: per
Are all members of the household full time students?   Yes    No
Do you have a pet?   Yes    No   Pet Type:
Do you smoke?   Yes    No

Source Of Income Of All Persons Over 18 Years Of Age:
Employer Address Position Monthly
Phone Length of
Total Annual Income:

Credit and Financial Information:
Account Number Bank/Institution Branch
Savings Account:
Checking Account:
Money Market or Similar Account:
Credit Accounts
& Loans
Type of Account
(Auto loan, Visa, etc)
Name of Creditor Amount
Monthly Payment
Major Credit Card:
Major Credit Card:
Other Major Obligation:

Vehicle(s) Information:  
License Plate Number:
Driver's License Number:
License Plate Number:
Driver's License Number:
Do you own any real estate?   Yes    No       Value:
Have you filed for bankruptcy within the last 2 years?   Yes    No
Person to notify in case of emergency:

Residence History - Present and Previous:  
Present Address:
City:        State:        Zip:        Phone:
How Long:     Rent Amt:      Reason For Move:
Previous Address:
City:        State:        Zip:        Phone:
How Long:     Rent Amt:      Reason For Move:

Tenant References:  
Name Address City, State, Zip Phone Number
Have you ever been evicted:   Yes    No     
If Yes, explain:
Have you or anyone in the house ever been convicted of a crime other than a traffic violation:
                                            Yes    No    
If Yes, explain:
Have you or anyone in your household been or are currently an illegal user of or addicted to a controlled substance or have you ever been convicted of the illegal manufacture or distribution of a controlled substance:                            Yes    No    
If Yes, explain:

I UNDERSTAND:  That the statements made on this application are considered a part of my lease (if accepted) and approval or disapproval will be based upon information furnished herein. If at any time it is determined that any information I have given is false, it will be a breach of the lease contract and appropriate action will be taken. I attest that all income information is true and correct.

WARNING:  Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful, false statements of misrepresentation to any department or agency of the U.S. to any matter within its jurisdiction.

The information regarding race, national origin, and sex designation solicited on this application is requested in order to assure that Federal Laws prohibiting discrimination against tenant applicants on the basis of race, color, national origin, religion, sex familial status, age and handicap are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way.

By submitting this application, I/We authorize Hardin County Properties, LLC, Radcliff Properties, LLC, TransUnion, VeriCorp, or any other third party agent, to obtain information about me/us from my/our credit sources, credit bureaus, civil and/or criminal court records, motor vehicle records, current and previous landlords and employers and personal references. I/We authorize my/our credit sources, credit bureaus, current and previous landlords and employers, and personal references to disclose to Hardin County Properties, and/or Radcliff Properties, LLC, such information about me/us as either of them or their third party agents may request. I/We further authorize ongoing procurement of the above mentioned reports at any time during my/our tenancy and/or when necessary to aid in eviction and/or collection.


Application Completed By:
Completed By Co-Applicant (for multiple applicants only):
Completed By Co-Applicant (for multiple applicants only):
Completed By Co-Applicant (for multiple applicants only):

Daytime Phone Number:     Evening Phone Number:
E-mail Address: