ATTENTION: A Charge of $75.00 PER HOUSEHOLD APPLICATION MUST be collected at time of application
for processing fees. (Cash or Certified funds ONLY (Money Order, Cashiers Check, etc.)

APPLICATION FOR
RESIDENTIAL RENTAL

1101 S. George Street
Charles Town, WCV 25414
304-725-1491

Applicant Requirements:
1. Each applicant shall have a good credit rating, which will be verified through a credit-reporting agency. An
adverse report such as delinquent accounts or unpaid judgments may disqualify applicant.
2. Applicant’s employment and/or other sources of income must be verified. Length of employment and/or job
stability will be a factor of consideration. Applicants who are self- employed or retired must provide verification
of income at the time application is submitted, (e.g. 1099).
3. Current and prior landlord references will be checked. Failure to pay rent on time, to give thirty-day notice in
writing prior to termination of tenancy, to protect property, or to respect the rights of other residents may
disqualify the applicant. Applicant’s willingness to and ability to care for his/her current and prior residence will
be confirmed.
4. Applicants must be at least 18 years of age in order to sign the rental agreement All occupants over the age of 18
must sign the rental agreement.
5. Rental agreements for our properties vary between month to month and six to twelve month leases.
6. Residents are encouraged to carry their own renters insurance on personal property. Management and owners are
not responsible for damage to the resident’s personal property and /or automobiles, that is not the result of
Management or owner negligence.
7. By signing this rental agreement, you are giving permission for your financial information (Salary/wages) to be
released for the purpose of tenancy verification.

FIRST MONTH’S RENT AND SECURITY DEPOSIT MUST BE PAID BY CASHIERS CHECK, CASH OR
MONEY ORDER

ATTENTION

A photocopy of a valid driver’s license or identification card must accompany all applications. Must provide copy of one month paystubs for all applicants.

ATTENTION

In the event of co-tenant(s) other than Spouse/Domestic Partner, use separate application for each tenant

Co-tenant Information if Applicable

Additional Occupants

Please provide Name, Relationship and Age

Pets

Vehicle

Current

Previous

Co-tenant

I DECLARE THAT THE FOREGOING IS TRUE AND CORRECT. AND AUTHORIZE ITS VERIFICATION AND THE OBTAINING OF A CREDIT REPORT.

I agree that the landlord may terminate any agreement entered into in reliance on any misstatement made above.

ALL Application must be accompanied by a Photocopy of a valid Driver’s License AND Must Provide ONE Month Paystubs

Thank you
Shultz Realty in Charles Town, WV

The Chaz Shultz Real Estate Team

1101 S George St

Charles Town, WV 25414

Phone: 304-279-9008

Email:

Chaz Shultz - ccshultz@shultzrealty.com

Kenneth F. Lowe Jr, Broker - klowe@clarionshepherdstown.com

Business Hours:

Monday - Friday 10:00 AM - 5:00 PM

Saturday & Sunday - By Appointment