Practical Practice Reading
Filling Out Forms
EREM 435
A Teaching Resource From
©2022
Copyright by Remedia Publications, Inc.
All Rights Reserved. Printed in the U.S.A.
The purchase of this product entitles the individual teacher to reproduce copies for classroom use.
The reproduction of any part for an entire school or school system is strictly prohibited.
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Remedia Publications, Inc.
Scottsdale, AZ
This product utilizes innovative strategies and proven methods to improve student learning.
The product is based upon reliable research and effective practices that have been replicated
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INTRODUCTION
As students make their way into the “real world,” learning the important skill of filling
out all different kinds of forms will make life much easier. The practice with forms in this
book strengthens a student’s abilities in reading, comprehension, spelling, writing, and
following directions.
The light-hearted story of Ferdie Fillemout is told through the forms that have to be
filled out during the course of his growing up. Silly names and engaging pictures make
the task of filling out the forms much more appealing and fun. We start with Ferdie’s birth
certificate, and move to the application for a social security number, student information
form, getting a driver’s license, filling out a job application, and more.
Follow up questions and Form Review pages test the student’s understanding of how
to fill out various forms.
TABLE OF CONTENT
Ferdie’s Forms Facts Sheet...............................1
Bank Account..........................................16-17
Birth Certificate..........................................2-3
Rental Application...................................18-19
Social Security Number...............................4-5
Lease Agreement.....................................20-21
Student Information....................................6-7
Change of Address........................................22
Driver’s Permit & License.............................8-9
Credit Application...................................23-24
Automobile Title...........................................10
Warranty Registration...................................25
Class Schedule..............................................11
Forms Review..........................................26-27
Job Application........................................12-13
Student Information Practice Pages.........28-29
Bank Account Application.......................14-15
Answer Key...................................................30
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FILLING OUT FORMS
Ferdie’s
Fact
Sheet
FERDIE’S
FORMS
FACTS
SHEET
Full Name
Ferdinand Franklin Fillemout
Date of Birth
May 10, 2004
Place of Birth
(city) Madison, (state) Wisconsin, (county) Dane
Social Security Number
222-44-1113
Mother’s Maiden Name
Frances Fenton Formly
Mother’s Social Security Number
222-44-1114
Father’s Full Name
Frederick Francis Fillemout
Father’s Social Security Number
222-44-1115
Address #1
634 Elm Street
Madison, Wisconsin 53701
Years There
2004 – 2023
Phone Number
608-333-9264
Address #2
2215 Hoyt St.
Chicago, Illinois 60607
Years There
2023 – 2028
Phone Number
872-333-4455
Address #3
863 N. Powell Blvd. Apt. 306
Chicago, Illinois 60607
Years There
2028 – Present
Phone Number
872-333-4455
Elementary School
Years Attended
Jackson Heights
September 2009 - June 2018
High School
Years Attended
Page Park
September 2018 - June 2023
College
Years Attended
University of Illinois
September 2023 - June 2028
©Remedia Publications
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Filling Out Forms
BIRTH CERTIFICATE
Through the course of everyone’s life, many forms need to be filled out.
This is the story of Ferdie Fillemout’s forms. As you follow the major events in his
life, you will learn about filling out different kinds of forms.
A Happy Day! Ferdie’s Birth!
In the beginning…Frederick Frances Fillemout
married Frances Fenton Formly. They lived at 634
Elm Street in Madison, Wisconsin.
On May 10, 2004, Mr. and Mrs. Fillemout
became the proud parents of a bouncing baby boy.
They named him Ferdinand Franklin Fillemout.
Ferdie (as his parents called him) was
born at 3:00 a.m. at Madison General
Hospital in the city of Madison. Madison is
in Dane county.
The doctor who
helped at Ferdie’s
birth was Dr. Angela
Marks, M.D.
After Ferdie was
born, his first form was filled out. It was his birth certificate.
Helpful Information:
• Maiden Name is a woman’s last name before she gets married.
Mrs. Fillemout’s maiden name is Formly.
• When a form asks for the sex of a person, it is asking if the person
is male or female.
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BIRTH CERTIFICATE
Name
Use the information on page 2 to complete Ferdie’s birth certificate.
STATE OF WISCONSIN
Certificate of Live Birth
1a. Child’s First Name
1b. Middle Name
1C. Last Name
2. Sex
3. Date of Birth
4. Time
5. Place of Birth
5a. County
5b. City
5c. Hospital
Father’s Place of Birth
Father’s Date of Birth
Mother’s Place of Birth
Mother’s Date of Birth
Pennsylvania
01/06/1972
Iowa
07/16/1974
Parent Signature
Relationship to Child
Date Signed
Doctor’s Name
Doctor’s Signature
6. Full Name of Father
7. Mother’s Full Maiden Name
Mother’s Street Address
How much do you know about what is on your own birth certificate?
Answer as many of the questions below as you can.
1. What is your full name (first, middle, last)?
___________________________________________________________________
2. In what city, state, and county were you born?
___________________________________________________________________
3. What time were you born?
___________________________________________________________________
4. At what hospital were you born?
___________________________________________________________________
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SOCIAL SECURITY NUMBER
Name
Making It Legal
Ferdie is just a baby. But he needs to get
his own social security number. It will be his
identification number his whole life. Ferdie will
need to use it on income tax returns, job and
rental applications, bank accounts, and other
forms. The reason Ferdie needs it now is so he
his parents can show the number on their income
tax returns. They will list him as their child.
Help Ferdie’s father complete the
Application for a Social Security Card form.
Answer the questions below and use
information from Ferdie’s Forms Facts Sheet
to complete the form on page 5.
1. What type of writing tool must be used to fill out the form?
________________
2. Look at item #1 on the form. How should Ferdie’s name appear on his social
security card?
___________________________________________________________________
3. In item #3, what does “Do Not Abbreviate” mean?
___________________________________________________________________
4. Complete items #6 and #7 with your own information.
5. Ferdie’s dad filled out the application exactly six months
after Ferdie’s birth. What date should be given for item #14?
________________
6. The Fillemout’s phone number in Madison was 608-333-9264.
Use this for item #15.
7. Feridie’s dad’s name goes on line 17. He is Ferdie’s natural father.
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SOCIAL SECURITY NUMBER
Name
SOCIAL SECURITY ADMINISTRATION
Application for a Social Security Card
INSTRUCTIONS
Print or type using black or blue ink. DO NOT USE PENCIL.
After you complete this form, take or mail it along with the required documents to your nearest Social Security office.
If you are completing this form for someone else, answer the questions as they apply to that person. Then sign your
name in question 17.
©Remedia Publications
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Filling Out Forms
STUDENT INFORMATION
Name
Ferdie’s Starting Kindergarten
It’s 2009, Ferdie is starting kindergarten. He’s very
excited. He already knows how to read and can count
to 100. He has been assigned a teacher. Her name is
Ms. Kristy Kindy.
Before Ferdie’s school starts in September, his parents
have to fill out a form. The form has information about
Ferdie and his family. His parents must mail the form so
it arrives at the school before September 1st.
Student Form Facts:
• Ferdie lives at 634 Elm Street in Madison, Wisconsin.
His mom’s cell number (and their home number)
is 608-333-9264.
• Ferdie’s mom Frances works at Wisconsin Tech.
Her work number is 608-443-8999.
• Ferdie’s dad Frederick works at Community
Center Bank. His work number is 608-555-9665.
• Ferdie’s grandmother is Phyllis Formly.
She lives down the street and is usually home.
She is an emergency contact for Ferdie.
Her cell number is 608-333-2201.
• Barbara Bingo is Ferdie’s mom’s
best friend. She lives next door.
She is always there to help in an
emergency. Her cell number is
608-229-3333.
• Ferdie is very healthy and has no medical problems.
His doctor’s name is Dr. Melodie Malady.
Her number is 608-222-8886.
• Ferdie’s dentist is Dr. Dennis Drill.
His number is 608-555-9550.
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STUDENT INFORMATION
Name
Before Ferdie starts school, a student information form has to be filled out.
Use the information on page 6 and on Ferdie’s Forms Facts Sheet to complete
this school form.
JACKSON HEIGHTS STUDENT INFORMATION FORM
Full Name of Student ___________________________________________________________
Student’s Address _____________________________________________________________
Date of Birth ______________________________ Home Phone _________________________
Mother’s Name ____________________________ Work Phone __________________________
Father’s Name____________________________ Work Phone __________________________
Does student have any allergies? If so, please list: ________________________________________
__________________________________________________________________________
Does student take any medicine on a regular basis? If so, please list: ____________________________
__________________________________________________________________________
Doctor’s Name ___________________________________ Phone _______________________
Dentist’s Name ___________________________________ Phone _______________________
In case of emergency, please give names of two friends or relatives other than parents in the event parents
cannot be reached.
Name____________________________________Phone _____________________ Relationship __________
Name____________________________________Phone _____________________ Relationship __________
Answer these Student Information questions about yourself, if you can.
1. What is your date of birth?
___________________
2. Do you have any allergies?
___________________
3. What is your doctor’s name?
___________________
4. What is your dentist’s name?
___________________
5. Who is your emergency contact?
___________________
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Filling Out Forms
DRIVER’S PERMIT & LICENSE
Name
Ferdie Learns to Drive
It’s 2019 and Ferdie is 15½. He has grown a lot in the last few years. He is
now 6’ 3” tall. He weighs 165 pounds. He has brown eyes and dark brown hair.
Ferdie just completed his Driver’s Education class. Now he can apply for a
Learner’s Permit.
PRINT Learner’s Permit application below. Use Ferdie’s Forms
CompletePLEASE
Ferdie’s
TEMPORARY
LEARNER’S
Facts Sheet to find his address
and date
of birth.PERMIT
Last Name
PLEASE PRINT
First
Middle
TEMPORARY LEARNER’S PERMIT
Street Address
Last Name
City
First
State
Middle
Zip Code
Street Address
Height
Weight
Eyes
City
Hair
State
Date of Birth
Height
Zip Code
Weight
Eyes
Hair
Date of Birth
Ferdie is finally 16. He passed his driver’s test and got his driver’s license.
Fill out the license below for Ferdie.
STATE OF WISCONSIN
FIRST NAME
MIDDLE NAME
LAST NAME
LICENSE NUMBER
X2584763
STATE OF WISCONSIN
STREET ADDRESS
FIRST NAME
MIDDLE NAME
CITY
EXPIRATION
LICENSE
NUMBER
05/10/2026
LAST NAME
STATE
X2584763
ZIP
STREET ADDRESS
SEX
WEIGHT
CITY
STATE
DATE OF BIRTH
SEX
EXPIRATION
HEIGHT
WEIGHT
EYES
HAIR
05/10/2026
ZIP
DATE OF ISSUE
HEIGHT 05/28/2020
EYES
HAIR
SIGNATURE
DATE OF BIRTH
DATE OF ISSUE
05/28/2020
Note: Use
numbers only when writing a date on a form. April 21, 2025
SIGNATURE
would be written as: 04/21/2025
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©Remedia Publications
DRIVER’S LICENSE
Name
Ferdie’s Driver’s License
Ferdie was very excited to get his driver’s license.
He texted all his friends to let them know the
good news!
Look at Ferdie’s driver’s license on page 8 to answer these questions.
1. What is Ferdie’s driver’s license number?
___________________
2. When does Ferdie’s license expire?
___________________
3. When was the driver’s license issued?
___________________
4. Ferdie has to renew his driver’s license every six years. Why do you think people
have to renew their driver’s license every few years?
__________________________________________________________________
__________________________________________________________________
What year will you be able to get your driver’s license? Imagine that it is that year.
How tall do you think you’ll be? What will your weight be?
Complete the license below for yourself. Your license will expire in five years
from the issue date. Be sure to write in the year the license will expire. Also
write in the state that is issuing the license.
STATE OF
FIRST NAME
MIDDLE NAME
LAST NAME
LICENSE NUMBER
M5624860
STREET ADDRESS
CITY
SEX
EXPIRES ON YOUR
BIRTHDAY IN
STATE
WEIGHT
DATE OF BIRTH
ZIP
HEIGHT
EYES
HAIR
DATE OF ISSUE
SIGNATURE
©Remedia Publications
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AUTOMOBILE TITLE
Name
Ferdie’s First Car
On Ferdie’s 17th birthday, his parents bought him
a car. Ferdie and his dad found a used 2010 Chevy
Malibu that was in good shape. Now Ferdie must
apply for a Certificate of Title and Registration to
show that he is the new owner of the car.
Use Ferdie’s Forms Facts Sheet and the following
information to fill out the form below.
• The license plate number on the car is: BBC – 1188
• The car was first registered on: February 18, 2010
• The new registration is effective as of: May 14, 2021
• The vehicle identification number (VIN) is: OM46B792887
• The make of the car is: Chevrolet • Body style: 2DHB •Year: 2010 • Model: Malibu
• Ferdie’s parents paid the list price of: $8,975
• Fuel used is: gasoline • GVW is 3,520
• Odometer Reading: 75,849 miles
• Ferdie’s driver’s license number: X2584763
MOTOR VEHICLE DIVISION
I certify that the information contained on this application is true and correct; that the vehicle is free from liens, except those indicated above and that I have
read and understand the requirements of the legal status indicated above. I acknowledge that the odometer reading above is qualified by the seller and that
it is not the responsibility of the Motor Vehicle Division to determine the accuracy of the odometer statement. I understand that vehicles registered for use in,
or used to commute into, Air Quality Control Areas (including Phoenix or Tucson) may be subject to emission testing.
OWNER
SIGN HERE
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CLASS SCHEDULE
Name
Ferdie’s Senior Year
In September 2022, Ferdie became a senior at
Page Park High School.
Ferdie needs to choose classes for his last year of
high school. His counselor, Ivan Listing, reminded him
he still had to choose one course in math, science,
English, social studies, and physical education. Plus,
he has an elective class he can choose.
Read the course list below and select one course from each category to
complete Ferdie’s Class Schedule.
Course Listing for Page Park High School Seniors
MATH
Course #
101101
102102
103103
Title Title
Course
Algebra
I
Algebra
2
Math
Concepts
Integrated Math
Statistics
Advanced Math
SCIENCE
ENGLISH
Course
Course
Title
CourseNo.
# Course
Title
Course
Course
Course No.
# Course
TitleTitle
PHYSICAL EDUCATION
ELECTIVE
Course
Course
Title
CourseNo.
# Course
Title
Course
Course
Course No.
# Course
TitleTitle
201201
202202
203203
SOCIAL STUDIES
Course
Course
CourseNo.
# Course
TitleTitle
401401
402402
403403
American
History
Current
Events
World
History
World
History
Sociology
World Geography
501501
502502
503503
Botany
Zoology
Biology
Botany
Physics
Chemistry
Freshman P.E.
Swimming
Swimming
Racquet
Sports
Weight
Training
Racquet
Sports
301301
302302
303303
601601
602602
603603
English Literature
American
Literature
Composition
Composition
Creative
Writing
English
I
Ceramics
Graphic
DesignI
Journalism I
Photography
Drama
Woodworking
Class Schedule
Name of Student ________________________________________________________________
LAST
Year (circle one)
FIRST
Freshman
Sophomore
MIDDLE
Junior
Senior
Name of Counselor _______________________________________ School Year _____________
COURSE NO.
©Remedia Publications
COURSE TITLE
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JOB APPLICATION
Name
Ferdie’s First Job
During Ferdie’s senior year, he decided to
get a part-time job. Ferdie turned 18 in May.
Nature’s Market is looking for a cashier. To get
hired, Ferdie has to fill out a job application first.
Nature’s Market does it the old-fashioned way.
They use paper application forms.
Answer the questions and read the information below to fill out Ferdie’s
job application on the next page.
Use Ferdie’s Forms Facts Sheet for any other information.
1. Ferdie applied for this job on October 5, 2022.
2. How should this date be written on the form?_________________
3. Ferdie’s email address is ferdie-ff@myemail.com.
4. Ferdie wants to work 20 hours per week, He has a computer programming class
after school on Tuesdays and Thursdays. He can work from 5 p.m. to 10 p.m. on
Monday, Wednesday, Friday, Saturday, and Sunday. Use this information to fill in
the part of the application that asks what times and days Ferdie can work.
5. Ferdie can start working 5 days after being hired.
6. Ferdie has no job history. This is his first job.
7. Ferdie has is own car and can drive to work.
8. What high school does Ferdie attend? _____________________
He is a senior, how many years of high school has he completed? _____
9. Ferdie is using his neighbor Dr. Eric Sims as his first reference. He is an MD and
has known Ferdie his whole life. His number is 608-333-8999. He will also use his
school guidance counselor, May Fujiwara. She has known him since freshman
year. Her number is 608-999-0004.
10. Who is Ferdie’s emergency contact?
Check his Student Information Form to get this information.
________________________
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JOB APPLICATION
Name
PLEASE PRINT OR TYPE ALL INFORMATION
©Remedia Publications
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BANK ACCOUNT APPLICATION
Name
Ferdie Gets a Bank Account
Ferdie got the job at Nature’s Market. He works
as a cashier 20 hours per week. Ferdie decided he
needed to open a bank account so he could get a
checking and savings account. Ferdie is going to
have his paycheck automatically deposited into his
checking account.
Ferdie went online to fill out an application
for Regence Bank. The bank will review the
information and let Ferdie know if his application
is approved.
Answer the questions and read the information below to help Ferdie fill out his
Bank Account Application. Use Ferdie’s Forms Facts Sheet for the rest
of the information.
1. What is Ferdie’s email address? _____________________________
2. Since Ferdie is still in high school, he lives at home with this parents.
Use address #1 on Ferdie’s Forms Facts Sheet. He has lived there his whole life.
3. Ferdie’s cell phone number is: 608-222-3636.
4. The number for Nature’s Market is: 608-666-9990
5. Ferdie is using his car insurance bill as proof of address.
6. What is Ferdie’s driver’s license number? ______________________
Refer to page 8 to see Ferdie’s driver’s license.
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BANK ACCOUNT APPLICATION
Name
BANK ACCOUNT APPLICATION
APPLICANT INFORMATION
APPLICANT NAME
LAST
FIRST
MIDDLE
EMAIL
ARE YOU AN EXISTING CUSTOMER? ○ YES ◉ NO
ADDRESS & PHONE
RESIDENTIAL ADDRESS
STREET
CITY
STATE
ZIP
HOW LONG HAVE YOU LIVED AT THIS ADDRESS?
HOME PHONE
BUSINESS PHONE
CELL PHONE
MAILING ADDRESS (IF DIFFERENT FROM RESIDENTIAL)
STREET
CITY
PROOF OF ADDRESS
○ RENTAL LEASE
STATE
◉ UTILITY BILL
ZIP
○ MORTGAGE
○ OTHER
CITIZENSHIP & TAX REPORTING STATUS
CITIZENSHIP STATUS
◉ U.S. CITIZEN
○ NON-RESIDENT ALIEN
COUNTRY OF CITIZENSHIP(IF NON-U.S. RESIDENT
DATE OF BIRTH
○ RESIDENT ALIEN
COUNTRY OF TAX REPORTING
SOCIAL SECURITY NUMBER
SECURITY INFORMATION
NAME OF FIRST SCHOOL ATTENDED
MOTHER’S MAIDEN NAME
IDENTIFICATION (RECORD THE DRIVER’S LICENSE OR PASSPORT NUMBER)
◉ DRIVER’S LICENSE
○ PASSPORT
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○ BIRTH CERTIFICATE
Filling Out Forms
BANK ACCOUNT
Name
Ferdie’s Bank Account
Ferdie’s bank account application was approved. He received
personalized checks, deposit slips, and a debit card. These are
all attached to his checking account. Before he can get
money out of his checking account he has to deposit
money into it.
1011
Ferdinand F Fillemout
634 Elm Street
Madison, WI 53701
REGENCE BAN K
Filling Out a Deposit Slip
1011
567891 234 : 442389 6655
list total from
other side
record check
number & amount
DEPOSIT TICKET
record cash
.
Cash
List Checks
Gimme Cash
111 East Money St.
Bank, AZ 85000
#1066
#2355
January 1, 2020
Date _________________________________
Total from Other Side
_____________________________________
SUBTOTAL
Sign here in teller’s presence for cash received
.
6 5 7 . 6 3
7 5 . 0 0
5 8 2 . 6 3
Less Cash Received
123456789:987654321
add above
items
3 6 7 . 9 8
2 8 9 . 6 5
TOTAL
request cash
back
total deposit amount
subtract cash recieved
from subtotal
Fill in the blank deposit slip for Ferdie so he will have some money in his
account. Use the following information:
Use Today’s Date • List Cash as $125.00 • List Check: #208 $589.68
Add the cash and the check amount to get the subtotal. Ferdie is getting no
cash back. The total is the same as the subtotal.
DEPOSIT TICKET
Cash
Ferdinand F Fillemout
634 Elm Street
Madison, WI 53701
.
.
Date _________________________________
_____________________________________
Sign here in teller’s presence for cash received
REGENCE BANK
567891234 : 4423896655
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List Checks
16
Total from Other Side
.
SUBTOTAL
.
Less Cash Received
.
TOTAL
.
©Remedia Publications
BANK ACCOUNT
Name
Writing a Check
One way to withdraw money from your
checking account is to write a personal
check. Printed on the check is your name,
address, check number, account number
and the bank’s routing number.
account holder’s information
payee
LOTTIE CASH
check number
823
January 1, 2020
____________________________
34 Penny Ln.
Anytown, AZ 85000
Ph. 555-1080
Pay to the
order of
date
Date
36.48
Sam’s Grocers
_________________________________________________
$ _________
Thirty-six and 48/100
_____________________________________________________________________________________
groceries
For _________________________
333456789
routing number
:
Dollars
________________________________
777654321
823
account number
signature
dollar amount
dollar amount
in words
Ferdie wrote his first check to pay for his car insurance. Use the following
information to fill out the check.
Date: Today’s Date Pay to: Safeco Insurance
Amount: $89.45
For: Car Insurance
Sign: Ferdie’s name
Ferdinand F Fillemout
634 Elm Street
Madison, WI 53701
1011
REGENCE BANK
567891234 : 4423896655
©Remedia Publications
1011
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RENTAL APPLICATION
Name
Ferdie Fills Out a Rental Application
Ferdie graduated from the University of
Illinois in June 2028. He has a degree in
Environmental Science. He got a research
job at Lake Michigan Labs in Chicago.
Ferdie found an apartment close to his
job that he would like to rent. First, he has to
fill out a rental application. Then he has to be
approved before he can move in.
Use the information below and Ferdie’s
Forms Facts Sheet to complete the
application on page 19.
1. Ferdie is the applicant for this two-bedroom
apartment. He does not need a co-signer.
The date is October 10, 2028.
2. Use Ferdie’s address on Hoyt St. in Chicago as his current address.
He was living in student housing while going to college so his rent was only
$750 per month.
3. Ferdie’s employer is Lake Michigan Labs. Their office is located at
848 Adams St. in Chicago, 60607. Their phone number is 872-333-2299.
Ferdie has been a researcher there for 4 months.
4. Ferdie adopted a 9-month-old Havanese puppy. He is excited
to have this new friend. The puppy’s name is Gus and he
weighs 13 pounds.
5. Ferdie now has an Illinois driver’s license. His driver’s license
number is: P342-7886-7732
6. Ferdie’s current car is a 2024 Toyota RAV 4. His Illinois
license plate number is: BG 88642
7. Sign and date the application for Ferdie. The date is
October 10, 2028.
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©Remedia Publications
RENTAL APPLICATION
Name
Applicant Co-Signer Date Requested: ______________ Unit Type: ___________________________
Applicant Name: ___________________________________________________
Driver’s License #:____________ State: ____ Home Telephone #: ____________
Co-Signer Name: __________________________________________________
Occupants: Indicate the number of persons to occupy the apartment (include yourself)
Name
Relationship
Social Security #
Driver’s License/State
Birth Date
1. _______________________________________________________________
2. _______________________________________________________________
Residency
Current Address: ___________________________________________________
City: _________________ State: __________ Zip: ____________
How Long: ____________ Monthly Payment: ___________
Landlord or Mortgage Company: ______________________________________
Reason for leaving: _________________________________________________
Employment
Current Employer: __________________________________________________
Address: _________________________ City: ___________________________
State: ________________ Zip: __________ Phone #: ____________________
How Long: ____ Position:__________________ Gross Monthly Income:_______
Pets: If you have any pets, please complete the following.
Name of Pet: __________________________ Type of Pet: __________________
Age: _______________Color: ____________ Size/Weight: __________________
Vehicle:
Make: ________ Model: _______ Year: ____ License Plate: ________ State:___
Make: ________ Model: _______ Year: ____ License Plate: ________ State:___
Applicant Signature: ________________________________________________
Date: ___________________________ Time: ___________________________
©Remedia Publications
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Filling Out Forms
LEASE AGREEMENT
Name
Ferdie Gets an Apartment
Ferdie’s rental application was approved! Now he has to
sign a lease. A lease is a contract between a landlord and a
tenant. Ferdie is now a tenant. He will fill out and sign the
lease agreement. This means that Ferdie is agreeing to the
terms of renting his apartment. And he is willing to follow
the rules.
Read the information below and use Ferdie’s Forms Facts
Sheets to complete the lease agreement on page 21.
1. The “Landlord” is PPMC Property Management at 865 N. Powell Blvd.
Chicago, Illinois 60607.
2. Ferdie is the “Tenant.” Use his current Chicago address for the “Address.”
The “Apartment Address” is: 863 N. Powell Blvd. Apt. 306, Chicago, Illinois 60607
3. Ferdie is signing the lease on Oct. 26, 2028. Enter this date next to
“Lease Date.”
4. The “Term of the Lease” is one year. The lease begins on Nov. 1, 2028 and
ends on Oct. 31, 2029.
5. “Monthly Rent” is: $2,750. “Security Deposit” is: $2,225. Look at item #2 to get
the added fee for pets. Write the total amount in “Monthly Rent.”
Answer the following questions about the Lease Agreement.
6. Read item #1. Can Ferdie invite friends to live with him? Why or why not?
__________________________________________________________________
7. Read item #3. When is rent due? _______________________________________
8. Read item #4. What must Ferdie do if he wants to paint his bedroom?
__________________________________________________________________
Filling Out Forms
20
©Remedia Publications
LEASE AGREEMENT
Name
The Landlord and Tenant agree to lease the apartment at the rent and for the terms stated below:
LANDLORD NAME: _____________________________________________________________________
ADDRESS: ____________________________________________________________________________
TENANT NAME: ________________________________________________________________________
ADDRESS: _____________________________________________________________________________
APARTMENT ADDRESS: _________________________________________________________________
LEASE DATE: _____________________________
TERM OF LEASE: ________________________
BEGINNING: ______________________________
ENDING: ________________________________
MONTHLY RENT: ___________________________
SECURITY DEPOSIT: ______________________
1. USE OF APARTMENT
This apartment may be used only as a space for living and for no other purpose. Only the
person signing this lease and his or her family may live in the apartment.
2. PETS
Pets are allowed on the premises only by obtaining the Landlord’s written permission first. Only pets
listed on the Rental Application will be allowed. “Pets” does not include animals trained to serve as
seeing-eye dogs, hearing dogs, or service dogs. In any case, when permission is granted, owners are
required to pay an additional $25 per month.
3. RENTAL PAYMENT
Monthly rent in the amount shown above must be paid on the FIRST of every month.
4. ALTERATIONS
Tenant must get written permission from Landlord to paint or wallpaper or make any other
permanent changes to the apartment.
Landlord and Tenant have agreed to the above terms as shown by the signatures below.
Signed: _____________________________________________________ Date: _________________
Signed: _____________________________________________________ Date: _________________
©Remedia Publications
21
Filling Out Forms
CHANGE OF ADDRESS
Name
Ferdie Moves to a New Place
Since Ferdie is moving to a new place, he must notify
the United States Post Office of his new address. Then the
Post Office can forward his mail. Ferdie went online to fill
out the “Change of Address” form.
Follow the steps below to fill out the Change
of Address form for Ferdie.
5. Ferdie’s email address is:
ferdie-ff@myemail.com.
Phone number is: 872-333-4455
1. This is a permanent move for Ferdie.
2. The start date is Nov. 1, 2028.
3. The change of address is for Ferdie
only. (individual)
6. For old address use: 2215 Hoyt St.
Chicago, Illinois 60607
4. Enter Ferdie’s full name.
PERMANENT
Select Permanent if you have no plans to
move back to your old address.
7. New address use: 863 N. Powell Blvd.
Apt. 306, Chicago, Illinois 60607
TEMPORARY
Select Temporary if you plan to return to
your old address within 12 months.
WHAT DATE SHOULD WE FORWARD YOUR MAIL?
INDIVIDUAL
If it’s just you moving, complete one form
and select this option.
ENTER YOUR NAME
First
Middle
FAMILY
If everyone in your family is moving and has
the same last name, complete one form and
select this option.
Last
EMAIL ADDRESS
PHONE NUMBER
ENTER YOUR
OLD ADDRESS
ENTER YOUR
NEW ADDRESS
Filling Out Forms
22
©Remedia Publications
CREDIT APPLICATION
Name
Ferdie Gets a Credit Card
Now that Ferdie has a good job and a new apartment, he
decides to open a charge account at Manny’s Department
Store. First he has to complete a credit application.
The credit application has lots of information about
Ferdie. The store uses this information to decide if Ferdie
can have a credit card or not.
Use the information below and Ferdie’s Forms Facts
Sheet to complete the credit application on page 24.
1. Ferdie’s current address is: 863 N. Powell Blvd. Apt. 306, Chicago,
Illinois 60607. He has been living there for 4 months.
2. His previous address is: 2215 Hoyt St. Chicago, Illinois 60607
He lived there during college for 5 years.
3. His phone number is: 872-333-4455
4. Ferdie’s employer is Lake Michigan Labs. Their office is located at
848 Adams St. in Chicago, 60607. Their phone number is 872-333-2299.
Ferdie has been a researcher there for 1 year and 4 months.
5. Ferdie earns $8,250 per month at his job.
6. Ferdie has a checking sand savings account at Regence Bank.
His checking account number is: 66578009
His savings account number is: 778-2336
7. Ferdie’s landlord is PPMC Property Management.
8. Ferdie’s monthly rent is $2,775.
9. Ferdie has one creditor. He has a loan with Regence Bank.
He owes $2,125. His monthly payment is $125.
©Remedia Publications
23
Filling Out Forms
CREDIT APPLICATION
Name
APPLICANT INFORMATION
LAST NAME
FIRST NAME
SOCIAL SECURITY NO.
MI
BIRTH DATE
TELEPHONE
CURRENT ADDRESS
APT. NO. HOW LONG?
Yrs.
CITY / STATE / ZIP
Rent
Own
Live with Others
PREVIOUS ADDRESS
APT. NO.
HOW LONG?
Yrs.
Months
Rent
Own
Live with Others
CITY / STATE / ZIP
EMPLOYMENT INFORMATION
CURRENT EMPLOYER
Months
POSITION
Yrs.
Months
STREET ADDRESS
PHONE NUMBER
CITY / STATE / ZIP
GROSS MONTHLY INCOME
OTHER INCOME SOURCE
MONTHLY AMOUNT
CREDIT REFERENCES
CHECKING ACCOUNT
BANK
SAVINGS ACCOUNT
BANK
ACCOUNT NO.
ACCOUNT NO.
LANDLORD’S NAME (if renting)
MONTHLY RENT
NAMES OF CREDITORS (List banks, department stores, finance companies, amount
owed, and monthly payment amount.)
Filling Out Forms
24
©Remedia Publications
WARRANTY REGISTRATION
Name
Ferdie Buys a Smart TV
Ferdie was approved for a Manny’s Department
Store credit card.The first thing he charged was
a Smart TV. It came with a limited warranty. A
limited warranty is a guarantee from the company
that made the TV. The company guarantees that
the new TV works and has nothing wrong with it.
Read the warranty that came with Ferdie’s
TV. Then answer the questions.
Smart TV Limited Warranty
Your Manny’s Smart TV will be repaired or replaced, if it proves to be defective in material or
workmanship under normal use, during the warranty period of 90 days. Warranty is effective
from Date of Purchase. The warranty is good only for the original purchaser. In order to receive
the benefit, owner must complete the warranty registration card and return immediately.
1. If the TV stops working 120 days after the purchase, will Manny’s replace it?
Explain your answer.
__________________________________________________________________
2. If the TV breaks after 60 days, what will Manny’s do?
__________________________________________________________________
3. What must Ferdie do to get this warranty?
__________________________________________________________________
Complete this Limited
Warranty Registration Card
for Ferdie. To find Ferdie’s
current address check his
Credit Application.
Limited Warranty Registration
MODEL
A3L890
Date of Purchase _______________________________________
Owner’s Name _________________________________________
Address ______________________________________________
City/State/Zip __________________________________________
Ferdie purchased the TV on
May 10, 2029. The dealer is
Manny’s Department Store at
#36 Park Plaza Mall,
Chicago, Illinois 60608
©Remedia Publications
Dealer’s Name _________________________________________
Address ______________________________________________
City/State/Zip __________________________________________
PLEASE FILL OUT THIS CARD AND MAIL IMMEDIATELY.
25
Filling Out Forms
FORMS REVIEW
Name
Ferdie Becomes a Dad!
Five years after Ferdie got his job and his
apartment, he fell in love and got married.
Ferdie and his wife Fiona recently became
parents! The second bedroom in Ferdie’s
apartment is now a nursery.
As you have learned throughout this book,
Ferdie’s life has been filled with all kinds of
forms. Now, Ferdie will start filling out forms for
his son, Frankie.
Use what you have learned about filling out forms to answer the questions below.
1. What form did Ferdie need to complete at the hospital right after Frankie was born?
__________________________________________________________________
2. What important information is included on this form?
__________________________________________________________________
__________________________________________________________________
3. Why do you think this form is important?
__________________________________________________________________
4. What kind of identification number will Ferdie need to get for Frankie?
__________________________________________________________________
5. What kind of form will need to be filled out when Frankie starts school?
__________________________________________________________________
6. Why do you think the school needs this information on Frankie?
__________________________________________________________________
Filling Out Forms
26
©Remedia Publications
FORMS REVIEW
Name
Use what you have learned about filling out forms to answer the questions below.
1. When you are in high school, what kind of form might you complete to show
what classes you want to take?
__________________________________________________________________
2. After getting a Temporary Learner’s Permit and passing a driver’s test, what will
you most likely get?
__________________________________________________________________
3. What form must you fill out when you buy a car?
__________________________________________________________________
4. If you want to get a job, what form must you fill out for the employer?
__________________________________________________________________
5. Once you are approved to rent an apartment, what form must you sign?
__________________________________________________________________
6. What form do you fill out for the Post Office when you move?
__________________________________________________________________
7. What do you need to do to get a bank account?
__________________________________________________________________
8. To put money into your checking account, what do you fill out?
__________________________________________________________________
9. What do you fill out to get a warranty on a product you purchased?
__________________________________________________________________
10. To be able to charge something at a store, what do you have to do?
__________________________________________________________________
11. When you are looking for an apartment, what application will you have to fill out?
__________________________________________________________________
12. What kind of form do you think you would have to fill out if you were getting married?
__________________________________________________________________
©Remedia Publications
27
Filling Out Forms
STUDENT INFORMATION PRACTICE PAGE
Name
Fill in the information requested below about your family and yourself. Knowing
this information will be helpful for filling out forms. You may need to get help from
your family for some of the information. You can use this information to fill out the
Practice Student Information Form on page 29.
1. Write your first, last, and middle name.
__________________________________________________________________
2. Write your home address including city, state, and zip code.
__________________________________________________________________
3. Write your phone number and email address.
__________________________________________________________________
4. Where were you born? (city and state) What is your birthday?
__________________________________________________________________
5. How tall are you? How much do you weigh?
__________________________________________________________________
6. What color is your hair and your eyes?
__________________________________________________________________
7. Write the name of your school.
__________________________________________________________________
8. Name any allergies you have or any medicines you take.
__________________________________________________________________
9. What are your parents’ full names and birthdays?
__________________________________________________________________
__________________________________________________________________
10. What are each of your parents’ cell phone numbers and email addresses?
__________________________________________________________________
__________________________________________________________________
Filling Out Forms
28
©Remedia Publications
PRACTICE STUDENT INFORMATION FORM
Name
Fill out this form with your information. Please print using blue or black ink.
©Remedia Publications
29
Filling Out Forms
ANSWER KEY
Filling Out Forms
Page 4
Page 27
1. Class Schedule
2. Driver’s License
3. Title and Registration Application
4. Employment Application form
5. a Lease Agreement
6. Change of Address Form
7. fill out a Bank Account Application Form
8. a Deposit Slip or Ticket
9. Limited Warranty Registration Form
10. fill out a credit card application
11. a rental application
12. a marriage license
1. pen with blue or black ink
2. Ferdinand Franklin Fillemout
3. It means write out the whole word.
5. November 10, 2004
Page 9
1. X2584763
2. 5/10/2026
3. 5/28/2020
4. Answers will vary.
Page 12
2. 10/5/2022
8. Page Park High School, 3
10. Ferdie’s grandmother, Phyllis Formly
or Barbara Bingo
Page 14
1. ferdie-ff@myemail.com
6. X2584763
Page 20
6. No – only the person signing the lease and
family can live in the apartment.
7. the first of every month
8. get written permission
Page 25
1. The warranty is only for 90 days. Manny’s
won’t do anything.
2. Manny’s will fix it if the problem is due to normal use.
3. Fill out the Limited Warranty Registration and mail
it to Manny’s.
Page 26
1. His Birth Certificate.
2. date of birth, child and parents’ names, where
child was born, where and when parents were born,
address of parents
3. Answers will vary.
4. Social Security Number
5. Student Information Form
6. Answers will vary.
Filling Out Forms
30
©Remedia Publications
Copyright by Remedia Publications, Inc.
All Rights Reserved.
The purchase of this product entitles the individual teacher to reproduce copies for classroom use.
The reproduction of any part for an entire school or school system is strictly prohibited. Copying
any part of this product and placing it on the Internet is strictly prohibited, including personal and
classroom websites. Doing so is a violation of the Digital Millennium Copyright Act (DMCA).