Application To Rent Form

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APPLICATION TO RENT
Individual applications required from each adult occupant (All sections must be completed)
Date _________________
Last Name __________________________ First Name ____________________________ Date of Birth _______________
Social Security # ______________________ Driver’s License # _________________________ State _____________________
Home Phone _____________________ Work Phone_____________________ Alternate Phone______________________
1.
Present Address ____________________________________ City ____________________ State _________ Zip _________
Date In: __________ Date Out:__________ Owner/Manager Name _____________________ Phone ___________________
Reason for Leaving____________________________________________________________________________________
2.
Previous Address___________________________________ City ____________________ State _________ Zip _________
Date In: _________ Date Out:__________ Owner/Manager Name _____________________ Phone ____________________
Reason for Leaving____________________________________________________________________________________
Age
Name
Date of Birth
Social Security #
Drivers License #
Name & Age
Of Other
Occupants
1.
Present Occupation _________________________________
Employer Name ___________________________________
How Long __________ Name of Supervisor _____________________________ Phone # ____________________________
Address ____________________________________ City _________________________ State _______ Zip ___________
Current Gross Income ______________________________
2.
Prior Occupation ___________________________________
Employer Name ___________________________________
How Long __________ Name of Supervisor _____________________________ Phone # ____________________________
Address ____________________________________ City _________________________ State _______ Zip ___________
Name of Bank _____________________________ Address _________________________________ Checking ____ Savings ____
List all Financial Obligations:
Creditor Name
Address
Phone #
Monthly Payment
Name
Address
Phone
City, State, Zip
Relationship
In Case of
Emergency:
Name
Address
Phone
Years Known
Occupation
Personal
References:
Have you ever been convicted/accused of a crime against persons or property? _________ Filed a petition in Bankruptcy? _________ Have
you ever been evicted?__________________
Applicant represents that all of the above statements are true and correct and hereby authorizes verification of the above items including but not limited to the obtaining of
credit reports and agrees to furnish additional credit references on request.
The undersigned makes application to rent housing accommodations designated as:
The rental for which is $ __________ per month and upon approval of this application agrees to sign a rental or lease agreement and to pay all sums due, including deposits,
before occupancy. An application fee of $ _____________ is non-refundable.
DATED: ___________________ 20_____
Signed:_____________________________________________________________
DATED: ___________________ 20_____
Signed: _____________________________________________________________
Utah Apartment Association
UNAUTHORIZED REPRODUCTION OF THIS FORM IS ILLEGAL
08/2006

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