Rental Application Form
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1Date _______________________________
Property ____________________________
R
A
ENTAL
PPLICATION
Rent $___________ Sec. Dep. $_________
Lease Term_________ Available ________
L
N
:
ANDLORD
AME
ALL APPLICANTS WILL BE SUBJECT TO AN INVESTIGATION OF CREDIT & RENTAL HISTORIES
NAME_________________________________________________SOC SEC NUM_______________________ DOB_______________
CO-APPLICANT_________________________________________SOC SEC NUM_______________________ DOB_______________
CURRENT ADDRESS________________________________________CURRENT LANDLORD________________________________
CITY / STATE / ZIP
________________________________________LANDLORD’S PHONE_________________________________
CURRENT PHONE # ________________________________________MONTHLY RENT PAID $_______________________________
HOW LONG AT THIS ADDRESS?______________________________REASON FOR MOVING?_______________________________
PREVIOUS ADDRESS_______________________________________PREVIOUS LANDLORD________________________________
CITY / STATE / ZIP
_______________________________________LANDLORD’S PHONE_________________________________
MONTHLY RENT PAID $________________________________
HOW LONG AT THIS ADDRESS?____________________________ REASON FOR MOVING? ________________________________
HAVE YOU EVER BEEN EVICTED? EXPLAIN_______________________________________________________________________
HAVE YOU EVER BEEN ASKED TO LEAVE? EXPLAIN________________________________________________________________
CURRENT EMPLOYER ____________________________________CURRENT POSITION___________________________________
EMPLOYMENT ADDRESS__________________________________EMPLOYMENT PHONE # ________________________________
CITY / STATE / ZIP
______________________________________SUPERVISOR’S NAME__________________________________
GROSS INCOME PER MONTH $_____________________________DATE HIRED? _________________________________________
PREVIOUS EMPLOYER ___________________________________POSITION_____________________________________________
EMPLOYMENT ADDRESS_________________________________EMPLOYMENT PHONE # _________________________________
CITY / STATE / ZIP
_________________________________SUPERVISOR’S NAME____________________________________
GROSS INCOME PER MONTH $___________________________REASON LEFT?_________________________________________
OTHER INCOME (ASSISTANCE, ALIMONY, ETC.)________________________________MONTHLY AMOUNT $_________________
SAVINGS ACCT AT______________________________________ACCOUNT NUMBER(S)___________________________________
CHECKING ACCT AT____________________________________ACCOUNT NUMBER(S)____________________________________
CREDIT ACCT(S)_______________________________________ACCOUNT NUMBER(S)____________________________________
HAVE YOU EVER FILED FOR BANKRUPTCY OR BECOME DELINQUENT ON ANY ACCOUNT? EXPLAIN______________________
HOW MANY PEOPLE WILL OCCUPY THIS RENTAL?________________
NAMES & RELATIONSHIPS OF ALL OCCUPANTS___________________________________________________________________
DOES ANYONE SMOKE?_____________________________DO YOU HAVE ANY PETS?_____________TYPE?_________________
CAR MAKE(S)______________________________YEAR(S)____________________LIC. PLATE #(S)__________________________
DRIVER’S LICENSE NUMBER & EXPIRATION DATE__________________________________________________________________
IN CASE OF EMERGENCY, CONTACT_____________________________________________________________________________
ADDRESS_____________________________________________PHONE__________________________
CITY / STATE / ZIP _____________________________________RELATIONSHIP____________________
I certify that all information given herein is true and complete. During the application process and at any
-- Office Use Only --
time during tenancy or after termination, I authorize the investigation of all statements contained in the
Date app rcvd_________________
application including information regarding my credit worthiness, credit standing, credit capacity, character,
Verified:
rental
employ
general reputation, personal characteristics, or mode of living. This report may be compiled with information
credit
criminal
from credit bureaus, court record repositories, criminal history repositories or databases, past or present
S/D Rcvd________
landlords or employers, department of motor vehicles, department of corrections or any other source
Rent Rcvd________
required to verify information that I have voluntarily supplied. I understand that any false, misleading or
Balance due___________________
negative information may result in the rejection of my application and/or the termination of my lease.
Move in date__________________
Approved
Rejected
Applicant’s Signature________________________________________
___________
Date:
App processed by: ______________
Co-applicant’s Signature______________________________________
___________
Date:
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