Brickel Shores - Rental/Purchase Application

"*" indicates required fields

Community Address*

Rental or Purchase?*

Rental

Purchase

Marital Status*

Single

Married

Birth Date*

Applicant's Name*

Current Address*

Contact Phone*

Contact Email*

Spouse Name*

Spouse Phone*

Spouse Email*

Current Address*

Emergency Contact Name*

Emergency Contact Relationship*

Emergency Contact Email*

Current Address*

Emergency Contact Phone*

Emergency Contact Cellphone*

Vehicle Information*

Vehicle Owner*

Vehicle Type*

Vehicle Make*

Vehicle Model*

Vehicle Year*

Vehicle Color*

Plate Number*

State*

Employer's Name*

Current Address*

Employer's Phone*

Supervisor's Name*

Have You Ever Been Evicted or Asked to Leave a Residence?*

Yes

Consent*

I Authorize P|R to run background check

Color copy of Applicant's Driver's License*

Max. file size: 256 MB.

Copy of Marriage Certification

Max. file size: 256 MB.

(if applicable)

Copy of Proof of Employment (Paystub, etc)*

Max. file size: 256 MB.

Copy of Vehicle Registration*

Max. file size: 256 MB.

Copy of Vehicle Insurance*

Max. file size: 256 MB.

Copy of Rental/Lease Agreement or Sales Contract (Executed by all parties)*

Max. file size: 256 MB.

Copy of (2) two references*

Max. file size: 256 MB.

For the following Communities selected, must show proof of Security Deposit:

Max. file size: 256 MB.

Brickell Shores | International Towers | Normandy Place | Sunset Villas Phase III | Waterway Isles

Type Your Name*

I accept and acknowledge the rules and regulations

Price*

Price:

For the first person or married couple (with proof only)

Additional Person *

Price: $150.00

For each additional person who will occupy the unit 18 years of age or older

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code

Total

Half of the rental amount (Payable to the association)
Requires Signature for Rules and Regulations

Brickel Shores – Rental/Purchase Application

Brickel Shores - Rental/Purchase Application