CREDIT INFORMATION
Please list all your financial obligations
Name of Bank or Savings & Loan
Branch or Address
Account No.
Balance
Checking
$
Savings
$
Credit Accounts
Account No.
Address/City
Phone
Balance
Due Monthly
GENERAL INFORMATION
Check answer that applies
§ Do you smoke?
YES
NO
§ Do you have any pets?
YES
NO
§ Have you ever filed for bankruptcy?
YES
NO
§ Do you have any musical instruments?
YES
NO
§ Do you have any waterfilled furniture or do you intend to use
YES
NO
water filled furniture in the apartment?
§ Have you ever been convicted for selling, possessing,
YES
NO
distributing or manufacturing illegal drugs or convicted of any
other crime?
§ Have you ever been evicted for nonpayment of rent or any
YES
NO
other reason?
Please explain any “yes” answers to the above questions:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Why are you leaving your current residence?____________________________________________________
________________________________________________________________________________________
The applicant hereby applies to rent/lease Apartment #_________at___________________________
________________________________for $__________ per month, and upon owner’s approval agrees to
enter into a Rental Agreement and/or Lease and pay all rent and security deposits required before
occupancy.
An application fee of $__________ is hereby submitted for the cost of processing this application, to obtain
credit history and other background information.
Applicant represents that all information given on this application is true and correct. Applicant hereby
authorizes verification of all references and facts, including but not limited to current and previous landlords
and employers, and personal references. Applicant hereby authorizes owner/agent to obtain Unlawful Detainer,
Credit Reports, Telechecks, and/or criminal background reports. Applicant agrees to furnish additional credit
and/or personal references upon request. Applicant understands that incomplete or incorrect information
provided in the application may cause a delay in processing which may result in denial of tenancy. Applicant
hereby waives any claim and releases from liability any person providing or obtaining said verification or
additional information.
Applicant:________________________________________Date:____________________________
(Signature required)