Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Home Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Cell Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Cell Phone Carrier {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Place of Employment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Work Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Driver's License Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Social Security Number (Last 4 Digits) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Picture of Driver's License Untitled {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
How long will you be storing with us? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
How did you hear about us? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Access Rights for Others
List other people you want specifically named in the rental agreement as having rights to the space, i.e., other persons to whom we my give a facility access code without us having to check with tenant for authorization. I authorize Discount Self Storage to contact these people if my unit becomes past due.
(1) First and Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
(2) First and Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
(3) First and Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Emergency Contacts
List other person(s) who we may contact in an emergency. Do not list persons living with you. These persons may have access under the very limited circumstances (affidavit of death, incarceration, permanently missing, or permanently incapacitated) as listed in paragraph 1 of the lease. I authorize Discount Self Storage to contact these people if my unit becomes past due.
(1) First and Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
(2) First and Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
(3) First and Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Credit Card Information
This form is secure. Credit Card numbers will remain hidden for your protection until we authorize payment.
{ binding firstError.message }
{ binding firstError.message }
Name on the Card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Billing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Credit Card Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue, convert=Cognito.maskText }
{ binding firstError.message }
Expiration Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
CVV2 # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
I authorize Discount Self Storage to withdraw payment form the above noted account. If payment on unit is not made prior to the agreed upon due date, Tenant authorizes Discount Self Storage to apply the total amount due to the above mentioned credit card on or after the said due date. Tenant also authorizes Discount Self Storage to use any credit/debit card I update at a future date.
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }