Apartment Reservation Form

For your convenience, we have compiled the following ifnormation to help make your transition go smoothly. Upon application approval and signing of the lease, your new address will be:


I authorize my full name below to act as my legal and binding signature.

    Listed below are the financial responsibilities for the apartment that you are reserving.

    Due upon application:

    Security Deposit (Refundable)

      • $520 (1 bedroom)
      • $635 (2 bedroom)
      • $550 (3 bedroom)

    Due monthly:

    Monthly Rent

        • $520 (1 bedroom)
        • $635 (2 bedroom)
        • $550 (3 bedroom)

    Late Fee is of total monthly rent

    All utility service will be disconnected from Fieldstone Apartments within 3 days of your move-in date. Please make sure that you have made the proper arrangements by your scheduled move-in date.

    Duke Energy 800-521-2232 http://www.duke-energy.com
    Indiana American Water 812-232-3454
    Time Warner Cable 812-232-5013 http://www.timewarnercable.com/terrehaute/

    Should your move-in date and/or lease term change prior to your originally scheduled move-in date, you will be responsible for either a) the new rental rate as generated by the pricing system on the day that the move-in date or lease term was changed, or b) rent from the originally agreed upon move-in date.

    Please review your application for information on refunds and forfeitures of fees and deposits.