JSC Rent To Own Homes

The Chicagoland Buyer's Choice Program

NOTE: This program is for Chicagoland only. Please do not fill out this form unless you are interested in the Chicagoland area. We will ignore any requests for any other area!

Application form (For a printer friendly version of this form, click here.)

APPLICANT'S FULL NAME_____________________________________________________________________

CO-APPLICANT'S FULL NAME_________________________________________________________________

APPLICANT'S CURRENT ADDRESS_____________________________________

STATE______________    ZIP CODE______________

APPLICANT'S PHONE_________________________

WORK PHONE _________________________________

CELL PHONE _______________________________

EMAIL ADDRESS________________________________

CO APPLICANT PHONE _______________________

WORK PHONE __________________________________

CELL PHONE ________________________________

EMAIL ADDRESS ______________________________


RESIDENTIAL HISTORY:


LANDLORD'S NAME__________________________________

LANDLORD'S PHONE____________________

HOW LONG AT THIS ADDRESS?________________________

MONTHLY RENT $_____________________

REASON FOR MOVING_______________________________________________________________________


PREV ADDRESS _____________________________________________________________________________

PREV LANDLORD'S NAME____________________________

PREV LL'S PHONE______________________

HOW LONG AT THIS ADDRESS?________________________

MONTHLY RENT $_____________________

REASON FOR MOVING_______________________________________________________________________



WORK HISTORY:


OCCUPATION_____________________________________ COMPANY:____________________________

YEARLY INCOME ( W-2 / 1099 / SELF EMPLOYED)____________________________________________

SUPERVISOR'S NAME________________________________________________________________________

HOW LONG AT THIS JOB? __________________________________ PHONE________________________

PREVIOUS OCCUPATION______________________________________
HOW LONG?__________________

OTHER INCOME & AMOUNT_________________________________________________________________



SPOUSE OCCUPATION_______________________________ COMPANY:__________________________

YEARLY INCOME ( W-2 / 1099 / SELF EMPLOYED)____________________________________________

SUPERVISOR'S NAME________________________________________________________________________

HOW LONG AT THIS JOB? ___________________________ PHONE_______________________________

PREVIOUS OCCUPATION______________________________________

HOW LONG?__________________

OTHER INCOME & AMOUNT_________________________________________________________________




FINANCIAL INFORMATION:

AMOUNT AVAILABLE FOR DOWN PAYMENT:_________________________________________________

MAXIMUM MONTHLY PAYMENT:____________________________________________________________

SOURCE OF DOWNPAYMENT FUNDS_______________________________________________________

ASSETS

SAVINGS ACCOUNT: BANK__BALANCE$____________________________________________________

CHECKING ACCOUNT: BANK_BALANCE$____________________________________________________

401K BALANCE:____________________________________________________________________________

STOCKS:__________________________________________________________________________________

DIVIDENDS:_______________________________________________________________________________

TRUST/CD:_______________________________________________________________________________

OTHER:__________________________________________________________________________________


CREDIT HISTORY

OPEN CREDIT CARDS

NAME and BALANCE:____________________________________
MONTHLY PAYMENT:_____________________

NAME and BALANCE:____________________________________
MONTHLY PAYMENT:_____________________

NAME and BALANCE:____________________________________
MONTHLY PAYMENT:_____________________

NAME and BALANCE:____________________________________
MONTHLY PAYMENT:_____________________

NAME and BALANCE:____________________________________
MONTHLY PAYMENT:_____________________

ALIMONY $______________________________________________________________________________

CHILD SUPPORT ( Y / N ) … IF YES, AMOUNT PAY MONTHLY ______________________________

STUDENT LOAN $_________________________ ALIMONY $________________________________


BANKRUPTCY? ( Y / N )…

IF YES, MONTH________________ YEAR____________________ CHAPTER ( 13 / 7 )

FORECLOSURE? ( Y / N )… IF YES, MONTH______________ YEAR_________________


TOTAL MONTHLY PAYMENTS ON ALL FINANCIAL OBLIGATIONS (CAR PAYMENT,
INSURANCE, CREDIT CARDS, ALIMONY, ETC.) EXCLUDING RENT

$____________________________________________


AUTOMOBILES:
AUTO #1

MAKE(S) & MODEL(S)________________________________ YEAR_______ PLATE#_____________

DO YOU OWN IT OUTRIGHT?_________________________ IF NO, MONTHLY PMT $__________

AUTO #2

MAKE(S) & MODEL(S)________________________________ YEAR_______ PLATE#_____________

DO YOU OWN IT OUTRIGHT?______________________ IF NO, MONTHLY PMT $_____________



PERSONAL INFORMATION:


SSN#____________________________ DRIVER'S LIC#_________________ D.O.B._______________

SPOUSE SSN#____________________ DRIVER'S LIC#_________________ D.O.B._______________

NEAREST LIVING RELATIVE ________________________________ PHONE___________________

OTHER PERSONS WHO WILL LIVE WITH YOU__________________________________________

ANY PETS? ( Y / N ) TYPE OF PET, WEIGHT & NAME___________________________________

HAVE YOU EVER REFUSED TO PAY RENT? ____________ WHY?__________________________

HAVE YOU EVER BEEN EVICTED? _____________ IF SO, WHEN?__________________________


I declare that the statements above are true and correct, and I hereby authorize verification of references and a consumer credit check. I agree to pay a NON-REFUNDABLE processing and credit check fee of $30.00. I also authorize the landlord, JSC INVESTMENTS, LLC. or its designees to obtain information about me from current and previous landlords and employers, criminal background checks and personal character references. I authorize my credit sources, current and previous landlords and employers, and personal references to disclose to JSC INVESTMENTS, LLC. or its designees such information about me as they may request. I understand that pursuant to Federal law, a may request in writing the name and address of the credit reporting agency used by the landlord. I understand that I may not receive a copy of the credit report from the landlord, but may request a copy directly from the credit bureaus.




______________________________________ _____________________________
APPLICANT'S SIGNATURE and DATE



______________________________________ _____________________________
CO-APPLICANT'S SIGNATURE and DATE

Fax your SIGNED and completed application to JSC Investments, LLC (708) 246-4329. Please send the required application with original signature and a check or money order for $30 to:

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