Floor Plans

Rent Application


Current Availability




Roselawn Apartments Rental Application

Print out and bring in. With application fee and valid id.


Name                                                                    DOB                  S.S.No.                               


Marital Status:                                   No. of Children                Age:                              

List all occupants                                                                                                                      

Home Phone Number:                                     Cell:                                     

Your Employer:                                                                           How Long?                    

Address of Employer:                                                        Phone No.                               

Spouse/Roommate Name                               DOB                  S.S.No.                               

Spouse/Roommate Employer:                                                    How Long?                    

Address of Employer:                                                       Phone No.                               

Spouse Monthly Income:                                Your Monthly Income:                                

Additional Income where does it come from?                                                 

                                                                   Total Monthly Income                                  

Present Address:                                                                                                             

Phone No.                                 Own         Rent          Landlord/Mortgagee:                                 

Is present rent up to date?   Yes   No  Have you given notice?   Yes    No   Have you been asked to leave?   Yes    No

Please provide current/past landlords with rent, name, and phone no.                                           



Nearest Relative (Emergency Contact)                                        Relationship                  

Address:                                                                           Phone No.                               

No. of Motor Vehicles in family which will be kept at residence:


Type                            Make                           Color                           License No.                 State


Type                            Make                           Color                           License No.                 State

Please list 2 personal references (include phone numbers):

1.                                                                                       2.                                                                         


No dogs, cats, or other pets allowed WITHOUT PET AGREEMENT.

I own a                                     .    NO PETS ALLOWED!!!! WITHOUT PET AGREEMENT.


I understand that I will forfeit my security deposit if I do not give 45 days written notice when moving.  Signed:                                            (Lessee(s)’ must provide forwarding address.)


Have any of the occupants listed above ever been:  convicted of a felony?                  Received a deferred adjudication for a felony?            been evicted?          Broken a lease             declared bankruptcy?                    


The representations herein made are true. Applicant hereby authorizes Landlord to verify all of the information in this application and obtain credit reports on the above listed applicant and/or applicant’s.  Tenant will be listed with LaPorte Property Management Association and NILA. One month’s rent security deposit is due upon signing this application.  The first month’s rent (prorated) is due before moving into the apartment.  All rent thereafter is due on the first day of the month in advance.  I am not renting room or another apartment under any other name. If for any reason you break this commitment your security will not be refunded to you.  The owners have the right not to approve you and your security deposit will be fully refunded.



A current and valid photo identification (such as Driver’s License) must be submitted prior to or with this application.


Application fee $    25.00  (NON-REFUNDABLE) cash or money order only (per adult over 18 years old)                         Monthly rent $                          

Security Deposit $                                             Key Deposit  $25.00            Apt assigned             W. 10th St. Apt .       

To commit to apt $                                 Balance due on                                                   is $                              .