ASHBY HOUSE

Extended Stay Lodging in Atlanta's Historic West End

Guest Rental Application
Rental Request
Please take a moment to complete this rental request.  Once it is completed, print it, click Submit below, sign the printed copy and fax it to Ashby House at 404-758-1100 or mail it to 1071 Martin Luther King Jr. Drive, NW, #201. Atlanta, GA  30314. Your signed authorization is required to process your request.  Form information will not save.   Thank You.
Guest Information
Full Name:
Telephone:
Permanent/Last Address:
Address:
City:
State:
Zip Code:
Driver's License Number/State
Citizenship:          
Email  Address:
Extended Stay Guests :
Employer:
Title/Position:
Contact Person
Telephone:
Work Address:
City/State/Zip:
Salary/Income:
How Long Employed?:  
Extended Stay Guests :
 Have You ever: Been Sued
How many times? 
  Filed For Bankruptcy
How many times? 

Sued Someone Else
How many times? 
  Been Evicted
How many times? 
  Been Convicted of a Crime?
How many times? 
Do you smoke? :
Explain any "Yes" answers:




Minors Require Co-Sign:
Extended Stay Reference:

Name

Relationship:
Email:
Telephone:

All Guests:  General Information/ Documents Needed
 Room Type Desired
      Check One
Private
Arrival Date:
Departure Date:

 Not sure about Length of Stay
Not sure how long I'll stay
 Photo ID Required
 Plus 1 Other ID
Driver's License #                                                State
  Proof of Income/Pay Stub (Most Recent)
 (Type ID - Please check) Government ID
  School
  Social Security card
  Other:
Other Information
Comments:

I certify that all the information given above is true and correct.  I understand that my rental agreement may be terminated if I have made any material false or incomplete statements in this application. By my signature below, I authorize the verification of the information provided on this form as to my credit, employment, criminal background check, and references.  This permission will survive the expiration of my rental.  I have reviewed and received a copy of this rental application.  If approved, I understand that I am a guest, not a tenant and agree to the rental terms and conditions, including Management's authority to evict and change the locks without notice for late/nonpayment and/or violation of rental terms and conditions.  I agree to voluntarily vacate the room if my rent and late fees are not paid within 5 days of the due date and that my deposit can be applied toward any past due rents/charges regardless of whether damage to the room is sustained. 


Signature:

Date:

             THANKS FOR YOUR INTEREST

            Print this form, Click Submit, Sign
     and Return the Signed Copy for Processing
          The Completed Form Will Not Save
FAX to 404-758-1100 or
email to
info@theashbyhouse.com


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