Occupant Only Application

Thank you for applying with Hauck Homes, Inc. Please fill out this form as completely as possible. Someone will be in contact with you shortly. If you have any questions, please contact the local manager or our main office at 815-201-2000.

*Property applying for How did you hear about us?

Contact Information

*First Name *Middle Name - N/A if None *Last Name *Telephone *Date of Birth *Social Security Number *Email Address

Current Address

*Address Suite/Apt *City *State *Zip *Landlord Name *Landlord Phone Number *Landlord Address *Length of Time at This Address

Personal Reference

*Reference Name *Reference Phone Number *Reference Relationship

Vehicle Information

*Vehicle Make *Vehicle Model *Vehicle Year

Occupants

List All Occupants. If any occupants are under 18 also list their ages.

*First Name *Last Name *Relationship *Age

Animals

*Do you have animals