Residential Rental Application Template Page 2
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1
2PET(S)
TYPE:
BREED:
WEIGHT:
FIXED?
TYPE:
BREED:
WEIGHT:
FIXED?
TYPE:
BREED:
WEIGHT:
FIXED?
TYPE:
BREED:
WEIGHT:
FIXED?
EMERGENCY CONTACT(S)
FULL NAME:
RELATIONSHIP:
CONTACT PHONE:
EMAIL ADDRESS:
FULL NAME:
RELATIONSHIP:
CONTACT PHONE:
EMAIL ADDRESS:
VEHICLE INFORMATION
YEAR
MAKE:
MODEL:
COLOR:
TAG #:
STATE
YEAR
MAKE:
MODEL:
COLOR:
TAG #:
STATE
DESCRIBE ANY OTHER VEHICLE, MOTORCYCLE, TRAILER OR BOAT YOU INTEND TO STORE OR PARK AT THE PROPERTY:
MANDATORY SCREENING QUESTIONS
Have you ever been evicted or a defendant in an eviction action?
YES
NO
IF YES, PLEASE EXPLAIN:
Have you ever filed, or are you in the process of filing, bankruptcy?
YES
NO
Do you owe any other landlords a balance?
YES
NO
Have you ever been asked to move for a lease violation of any kind?
YES
NO
Have you ever been convicted of a felony?
YES
NO
Have you ever been convicted of a major misdemeanor?
YES
NO
OTHER INCOME TO CONSIDER
CHILD SUPPORT
$
NAME & ADDRESS OF PAYER:
ALIMONY:
$
NAME & ADDRESS OF PAYER:
SOCIAL SECURITY:
$
DESCRIPTION OF BENEFITS:
DISABILITY BENEFITS:
$
NAME OR SOURCE OF PAYMENTS:
PUBLIC ASSISTANCE:
$
NAME OF ASSISTANCE PROGRAM:
OTHER:
$
DESCRIBE:
AUTHORIZATION TO RELEASE CONSUMER INFORMATION
Each person eighteen (18) years of age or older must be listed as an applicant on an application. If a co-signer is necessary, the co-signer must
also complete and sign an application, or guarantor form. $
Non-refundable processing fee (per applicant) will be collected with this
application, in order to process the application. Please completely fill in your application. If you do not, we will not be able to process the
application successfully.
Tenancy will be denied if any information is misrepresented on this application. If misrepresentations are found after the rental agreement is
signed, we have the right to terminate your rental agreement immediately, which would result in you being asked to leave the property. We utilize
a third party service to verify any or all of the following; your current and/or past employment, your current and/or past rental and eviction
history, your credit history and score(s), and review criminal records within the last 20 years on a nationwide scale. All applicants are processed
without regard to race, color, religion, sex, handicap, familial status or national origin.
This is to advise that I, the undersigned, hereby authorize Resident Research, LLC, acting as the landlord's designated screening organization for
the above-referenced rental property, to obtain a consumer credit report from any or all of the three credit bureaus, conduct a nationwide
criminal records search, nationwide eviction history search, to verify the details of my employment including salary information, and to obtain
a complete rental history from my current and/or former landlord(s) to determine eligibility for tenancy and assessing credit worthiness.
SIGNATURE OF APPLICANT:
PRINTED NAME OF APPLICANT:
DATE:
SIGNATURE OF CO-APPLICANT:
PRINTED NAME OF CO-APPLICANT:
DATE:
REVISION DATE: 12/17/2013
RESIDENTIAL RENTAL APPLICATION
PAGE 2 OF 2
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