Brickfield Residences
Managed Apartment Homes

Rental Application

One application per adult occupant · 18+

Thank you for your interest in Brickfield Residences. Please complete every section. A separate application is required for each adult who will live in the unit. A non-refundable screening fee applies.

Applicant
Maria T. Castellanos
04/18/1992
(555) 204-7781
XXX-XX-4416
Daniel R. Okafor
(555) 661-9032
The residence
Unit 4B — 2 bed / 1 bath
August 1, 2026
12 months
Current & prior housing
Address
Landlord / manager
Landlord phone
Rent / dates
218 Mercer St, Apt 3 — current
Hillcrest Mgmt
(555) 300-1180
$1,950 · 2yr
77 Aldine Ave — prior
R. Mehta (owner)
(555) 221-6604
$1,600 · 3yr
Employment & income
Lakeside Health System
Registered Nurse
$ 6,200
4 yrs
K. Reyes · (555) 880-2210
Vehicles, pets & emergency contact
2019 Honda Civic · 8KZ-441
1 cat, spayed
Non-smoking household 1 occupant 2 occupants Children under 18 Renter's insurance
Sofia Castellanos — sister
(555) 410-7765
Authorization & signature
Authorization to verify, screen & obtain reports

I certify that the information in this application is true and complete. I authorize Brickfield Residences and its agents to verify all information provided, to contact my employer and current and prior landlords, and to obtain a consumer credit report, rental-history report, and criminal-background report for the purpose of evaluating my tenancy. I understand the screening fee is non-refundable and that false or incomplete information is grounds for denial or for termination of any resulting tenancy.

Maria T. Castellanos
Applicant signature
June 17, 2026
Date
Nathan Cole
Co-applicant signature
June 17, 2026
Date

Brickfield Residences Equal Housing Opportunity We do not discriminate against any protected class.