Application To Rent Form

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APPLICATION TO RENT FORM
(PRINT CLEARLY)
Please complete one application for each person not related by blood or marriage. If a line is not filled in we will
return the application to you. You will also be required to present 2 pieces of identification for verification
purposes.
Date premises required: yr/m/d _______________________________
Rental Rate: ___________________ Security Deposit: ___________________ Screening Fee: ___________
Last Name: ___________________ First Name: ___________________ Middle Name: _________________
Date of Birth (yr/m/d): _____ / _____ / _____ (in some states it is not legal for a landlord to request a D.O.B.)
Social Security Number: ___ ___ ___ - ___ ___ - ___ ___ ___ ___
Driver’s License #: _______________________ State: ______________ Valid – Yes: _______ No: ________
Driver’s License Issued on (yr/m/d): _____ / _____ / _____ Expires (yr/m/d): _____ / _____ / _____
Current Address: ______________________________________ City: ________________________________
State: _____ Zip Code: ________Phone: (____)-_____-______ Email Address__________________________
How long residing at this address: ______ Rent Amount: _______Reason for Leaving_____________________
__________________________________________________________________________________________
Landlord’s Phone: (________)-________-________
Current Employer (name): _______________________________ Phone: (________)-________-________
Occupation: ______________________ How Long: ____Salary or Annual Income: _________
Previous Employer (name): _______________________________ Phone: (________)-________-________
Occupation: _______________ How Long: ____
Spouse’s Last Name: ___________________ First: _____________________ Middle: ___________________
Date of Birth (yr/m/d): ____ / ____ / ____ (in some states it is not legal for a landlord to request a D.O.B.)
Social Security Number: ___ ___ ___ - ___ ___ - ___ ___ ___ ___
Current Employer: ______________________________ Occupation: _________________________________
How long: ___________________Salary or Annual Income____________ Phone: (________)-______-_______
Vehicle Information (yr/make/model/color 1.): ________ / ________ / ________ / ________
Vehicle Information (yr/make/model/color 2.): ________ / ________ / ________ / ________
Vehicle License Plate Number 1: _____________________ State: ___________
American Application to Rent
October 2004
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