2013 Rental Application Form
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1
2
3OREGON
RENT L PPLIC TION
ALL UNITS
SUBJECT TO
TO BE COMPLETED BY EACH ADULT APPLICANT
AVAILABILITY
PROPERTY NAME / NUMBER
______________________________________________________________________________________________________________________________________________________________________________________________________________
UNIT NUMBER
ADDRESS
_________________________________________
__________________________________________________________________________________________________________________________________________________________________________
DATE UNIT WANTED
UNIT RENT $
SCREENING CHARGE $
________________________________________________________________
_______________________________________________
________________________________________________
OWNER / AGENT
PHONE
______________________________________________________________________________________________________________________________________________
_____________________________________________________________________
STREET ADDRESS
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
SMOKING POLICY: c SMOKING ALLOWED - ENTIRE PREMISES c SMOKING PROHIBITED - ENTIRE PREMISES
c SMOKING ALLOWED IN LIMITED AREAS (ASK MANAGEMENT FOR DETAILS)
APPLICANT FULL LEGAL NAME
EMAIL
_______________________________________________________________________________________________
________________________________________________________________________________________
PREVIOUS NAMES, ALIASES OR NICKNAMES USED
___________________________________________________________________________________________________________________________________________________________________
DATE OF BIRTH
SOC. SECURITY #
APPLICANT PHONE (
)
_____________________________________
__________________________________________________________
__________________
_________________________________________
GOVERNMENT ISSUED PHOTO I.D. TYPE
#
/ STATE
EXP. DATE
_____________________________________________
______________________________________________
__________________
_____________________________________
CURRENT STREET ADDRESS
______________________________________________________________________________________________________________________________________________________________________________________________________
CITY
STATE
ZIP
DATE YOU MOVED IN
____________________________________________________________
______________________
________________________________________________
____________________________________________________
CURRENT LANDLORD NAME
LANDLORD PHONE (
)
_________________________________________________________________________________________________________
__________________
_________________________________________
STREET ADDRESS (OR APARTMENT NAME)
________________________________________________________________________________________________________________________________________________________________________________
CITY
STATE
ZIP
__________________________________________________________________________________________________________
______________________________________________
__________________________________________________________________
APPLICANT FORMER STREET ADDRESS
____________________________________________________________________________________________________________________________________________________________________________________
CITY
STATE
ZIP
FROM
TO
____________________________________________________________
______________________
________________________________________________
___________________________________
___________________________________
FORMER LANDLORD NAME
LANDLORD PHONE (
)
___________________________________________________________________________________________________________
__________________
_________________________________________
STREET ADDRESS (OR APARTMENT NAME)
________________________________________________________________________________________________________________________________________________________________________________
CITY
STATE
ZIP
__________________________________________________________________________________________________________
______________________________________________
__________________________________________________________________
OTHER STATES AND COUNTIES YOU HAVE LIVED IN DURING THE PAST 5 YEARS
___________________________________________________________________________________________________________________
CURRENT EMPLOYER
PHONE (
)
______________________________________________________________________________________________________________________________________
__________________
_________________________________________
STREET ADDRESS
_______________________________________________________________________________________________________________________________________________________________________________________________________________________
CITY
STATE
ZIP
__________________________________________________________________________________________________________
______________________________________________
__________________________________________________________________
POSITION
HOW LONG? (DATE HIRED)
______________________________________________________________________________________________________________________________
__________________________________________________________
GROSS MONTHLY INCOME $
__________________________________________
/
OTHER MONTHLY INCOME: SOURCE
$
SOURCE
$
____________________________________________________
____________________________
____________________________________________________
____________________________
c YES
c NO
ARE YOU SELF-EMPLOYED?
c PREVIOUS c ADDITIONAL EMPLOYER
PHONE (
)
_____________________________________________________________________________________________________
__________________
_________________________________________
STREET ADDRESS
_______________________________________________________________________________________________________________________________________________________________________________________________________________________
CITY
STATE
ZIP
__________________________________________________________________________________________________________
______________________________________________
__________________________________________________________________
POSITION
HOW LONG?
_____________________________________________________________________________________________________________________________________________________
__________________________________________________________
IF ADDITIONAL EMPLOYER, GROSS MONTHLY INCOME $
__________________________________________
THE FOLLOWING INFORMATION IS SUBJECT TO CHANGE PRIOR TO EXECUTION OF RENTAL AGREEMENT.
SECURITY DEP. MINIMUM $
c IF CHECKED, RENTER’S INSURANCE WILL
THE FOLLOWING ARE MAXIMUM AMOUNTS. THE ACTUAL
____________________________
BE REQUIRED.
AMOUNT CHARGED WILL DEPEND ON UNIT SIZE,
SECURITY DEP. MAXIMUM $
SCREENING RESULTS, AND OTHER FACTORS.
____________________________
(DEPENDS ON SCREENING RESULTS AND UNIT SIZE)
MINIMUM INSURANCE AMOUNT:
$
MAXIMUM POTENTIAL RENT
____________________________
$
$
_________________________________________
____________________________
($100,000 IF LEFT BLANK)
____________________________
$
________________________________________
____________________________
$
_________________________________________
____________________________
$
________________________________________
____________________________
$
_________________________________________
____________________________
$
________________________________________
____________________________
$
_________________________________________
____________________________
$
________________________________________
____________________________
$
_________________________________________
____________________________
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