________________________________________________________________________________
___________________________________PERSONAL___________________________________

Applicant____________________________ ________________Birth Date___________________

Single _______________________________Partnered___________________________________

Birth Date___________ _____________________SS #___________________________________

SS#_________________________________D.L.#__________________________State_________


________________________________________________________________________________
___________________________________ADDRESSES_________________________________


Present Address__________________________________________________________________

City/State/Zip_____________________________________________________________________

Since_____________________Own________________________Monthly Rent_______________

Phone #___________________Cell #_________________"E" Mail_________________________

Landlord____________________________________Phone #_____________________________

Previous Address________________________________________________________________

City/State/Zip_____________________________________________________________________

From_________________To____________________Monthly Rent_________________________

Landlord____________________________________Phone #_____________________________


________________________________________________________________________________
__________________________________OCCUPANTS__________________________________


Number_________

Name____________________________________Relationship____________________________

Birth Date___________ _____________________SS #___________________________________


Name____________________________________Relationship____________________________

Birth Date________________________________SS_#___________________________________


________________________________________________________________________________
_______________________________________CAR_____________________________________


Make /Model/Color________________________________________________________________

Owner______________________________State__________Plate #________________________


________________________________________________________________________________
_____________________________________INCOME____________________________________


Current Yearly Income $___________________________________________________________

Bank/Credit Union__________________________Account #______________________________


Bank/Credit Union__________________________Account #______________________________


Bank/Credit Union__________________________Account #______________________________


________________________________________________________________________________
______________________________ALTERNATE CONTACTS____________________________


Relative Name___________________________________________________________________

Relationship_______________________________Phone #_______________________________

Address_________________________________________________________________________



Non-Relative Name_______________________________________________________________

Relationship_______________________________ Phone #_______________________________

Address_________________________________________________________________________


________________________________________________________________________________
______________________________CREDIT ACCOUNTS________________________________


Creditors Name________________________________Account  #_________________________

Address_________________________________________________

Creditors Name________________________________Account  #_________________________

Address_________________________________________________________________________


Creditors Name________________________________Account  #_________________________

Address_________________________________________________________________________


Creditors Name________________________________Account  #_________________________

Address_________________________________________________________________________


________________________________________________________________________________
_______________________________________PETS____________________________________


Type of Pet__________________________License #__________________State_____________

Size________________________________Weight______________________________________

Age_______________________________ Shots________________________________________

Spayed Or Neutered_______________________________________________________________




Applicant authorizes Rainbow Vista to contact past and present landlords, employers,
creditors, credit bureau, neighbors, and any others sources deemed necessary to investigate
applicant.

All of the information supplied to Rainbow Vista is true, accurate and complete to the best of
applicant’s knowledge. Rainbow Vista reserves the right to disqualify an applicant if the
information is not as represented.

ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE
UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FORM
AT ANY TIME.



X______________________________________________________Date_______________ _____
APPLICANT
Rainbow Vista LLC
Resident Application
Rainbow Vista LLC

Gay Active Senior
Living Community
You Can Print
The Resident
Application
Below & Mail it
in To Rainbow
Vista LLC.

To Request a
Copy Click The
Link: "Contact
Us / Map" and
We Will Mail
You a Copy.

Mail
Applications to:
Rainbow Vista
LLC, 1350 West
Powell Blvd,
Gresham, OR
97030