Residential Lease Application Form Page 3
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3Residential Lease Application concerning ______________________________________
Been evicted?
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Been asked to move out by a Landlord?
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Breached a lease or rental agreement?
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Filed for bankruptcy?
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Lost property in a foreclosure?
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Had any credit problems?
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Been convicted of a crime?
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In any occupant a registered sex offender?
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Are there any criminal matter pending against any occupant?
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Is there additional information Applicants want considered?
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Authorization & Representation: Applicant authorizes Landlord and Landlord’s agent,
at any time before, during or after any tenancy, to: (1) obtain a copy of Applicants credit
report; (2) obtain a criminal background check related to Applicant and any occupant;
and (3) verify any rental, employment, or criminal history or verify any other information
related to this application with persons knowledgeable of such information. Applicant
represents that the statements in this application are true and complete. Applicant
understands that providing false or inaccurate information is grounds for rejection and a
breach of any lease.
Notice: Unless agreed otherwise in writing, the Property remains on the market until a
lease is signed and Landlord may continue to show the Property to other prospective
tenants and accept another offer.
___________________________________________
_______________
Applicants Signature
Date
For Landlord use: On __________________(date) ,__________________(name/Initials)
Notified □Applicant
□ ______________________________
By □ phone □ mail □ fax □ email
□ in person ,
that Applicant was □ approved □ not approved
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