Fillable Rental Application Template printable pdf download

NEVER send your Social Security

RENTAL APPLICATION

number through e-mail

Applicant’s Last Name: ______________________________ First Name: __________________________________ M.I.: _______

Social Security # or ITIN: _________________________ Date of Birth: ________________ Contact Phone: ___________________

Photo ID Type: ______________________ Number: ____________________ Issuing government: ___________________________

Date expires: ____________ Other ID:_______________________ E-mail Address: _______________________________________

1. Present Address: _______________________________ City: _________________________ State: ______ Zip Code: ________

Owner/Manager: _____________________________ Phone (Required): _______________________ Rent Amount: ________

From/To: ____________________________________ Reason for Leaving: _________________________________________

2. Previous Address: ______________________________ City: _________________________ State: ______ Zip Code: ________

Owner/Manager: _____________________________ Phone (Required): _______________________Rent Amount: ________

From/To: ____________________________________ Reason for Leaving: _________________________________________

3. If applicable, Current or Previous Campus Address: _______________________________________________________________

From/To: ___________________________ Rent Amount: _____________________ Campus Housing Office: (831) 459-2394

Housing/Residential-Life Office Phone: ___________________________ Student ID #: ________________________________

Have you submitted a UCSC Reference Release to Campus Housing? ⁪ Yes

⁪ No ⁪ I will do it within 3 days

4. Proposed Occupants/Ages:

(1) _______________________ (2) _______________________ (3) _________________________

(4) _______________________ (5) _______________________ (6) _________________________

⁪ Yes

⁪ No

5. Pets: _______________________________________________________________________ Smoker:

6. Present Occupation: _______________________________ Employer: ___________________ From/To: ____________________

Name of Supervisor: _____________________________ Phone: ______________________ City: _______________________

7. Previous Occupation: ______________________________ Employer: ___________________ From/To: ____________________

Name of Supervisor: _____________________________ Phone: ______________________ City: _______________________

8. Current Gross Income: $ ____________________________ Per: ________________________ Savings: ___________________

9. Financial Aid Award: $____________________________________ Per: ______________________________________________

10. Personal Reference: _____________________________________ Phone: ___________________________________________

11. Emergency Contact: _____________________________________ Phone: ___________________________________________

_____________________________________

____________________________________

Relation:

E-mail:

12. Vehicles: Make/Year/License #: (1) ___________________________________________________________________________

(2) ___________________________________________________________________________

13. Address of Proposed Rental: ________________________________________________________________________________

14. Proposed Move-in Date: ___________________________

Applicant represents that all the above statements are true and correct and hereby authorizes verification of the above items including,

but not limited to, the obtaining of a credit report.

Dated: ____________________________________________ Applicant signature: _______________________________________ _

Reviewed 11/15

Rental Application Template