South Haven, MI 49090

(269) 274-9536

Complex: 722 North Shore Drive

Owners Name: Tony Penrose

Period of Occupancy:

Total # of Occupants Allowed: 12 (Allowed by owner and/or #sleeping surfaces)

Applicant Name & Email address ____________________________________________

Present Address: _________________________________

Street City State Zip

HOME & CELL Phone: _________________________________ Work Phone:_____________________

Supervisor: _________________Phone:_______________________

NAMES OF ALL OCCUPANTS (Mandatory)

__________________ __________________

__________________ __________________

__________________ __________________

Max of FOUR cars: 1)_________________ License #: _________

2)_________________ License #: _________

3) ___________________ Licence # ______________

4) ________________________ Licence # ___________________

Personal References:

1. _________________________________________________________

Name Address Phone

2. _________________________________________________________

Name Address Phone

IN THE EVENT OF EMERGENCY PLEASE CONTACT:

Name:_____________________Address:_______________

Phone:(___)_____-_________

The property rents for $6900.00 per week with a $800.00 security deposit. 250.00 is automatically deducted from the deposit for purposes of house cleaning...If you are interested in securing this rental please download the "Rental Agreement" & "Rules and Regulations" applications and fill out both completely. The $800.00 security deposit plus 50% of the rent ($3450.00 + 800.00 = $4250.00) is due at this time with the signed application.

Total monies of (6900.00 + 800.00 = 7700.00) are due 60 days prior to the week of rental. Certified funds may be made out to Tony Penrose. CANCELATION PLOCY: CANCELLING WITHIN 45 DAYS OF RENTAL DATE = NO REFUND. FULL REFUND OUTSIDE OF 45 DAYS.

Again, you may reach Mr. Penrose at 269-274-9536 with any questions.

REMEMBER, PLEASE SIGN AND RETURN BOTH THE RENTAL AGREEMENT AND THE RENTAL RULE ACKNOWLEGEMENT WITH YOUR DEPOSIT OF $4250.00 (CASHIER'S CHECK ONLY)

The above is understood and correct.

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Printed name.