Rental Application Form Page 2
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1
2Employment History
(If you are self-employed please attach your past 2 tax returns. If you are employed please attach your last 2 paystubs)
Employer Name & Address: ___________________________________________________________________________________
Supervisor Name: ____________________________________________________________________________________________
Supervisor’s Phone:_______________________________ Your Position/Title:___________________________________________
Salary/Wage: _______________________________ Dates of Employment: ____________________________________________
Additional Employer Name & Address: ___________________________________________________________________________
Supervisor Name:____________________________________________________________________________________________
Supervisor’s Phone:___________________________________ Your Position/Title:_______________________________________
Salary/Wage: ________________________ Dates of Employment: ___________________________________________________
Other Source of Income: ______________________________________________
Amount Monthly: ____________________
Other Source of Income: _____________________________________________
Amount Monthly: ____________________
References
Contact Name:
__________________________________________________________________________________________
Relationship: _____________________________________________________________________________________________
Phone Number: ___________________________________________________________________________________________
Contact Name:
__________________________________________________________________________________________
Relationship: _____________________________________________________________________________________________
Phone Number: ___________________________________________________________________________________________
Miscellaneous
Do you have pets?
Yes
No
If yes, please describe the pet. (breed & weight) __________________________________________________
__________________________________________________________________________________________
Does anyone in your household smoke?
Yes
No
Authorization – Tenant Disclosure and Release
In connection with my tenant application with you, I understand that consumer reports which may contain public record
information may be requested to evaluate my rental application. These reports may include the following types of information:
names and dates of previous employers, public records, credit data, bankruptcy proceedings, eviction and criminal records, etc.,
from federal, state and other agencies which maintain such records. I hereby authorize procurement of consumer report(s). If
approved as a tenant, this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer
reports at any time during my contract period.
________________________________________________________________
Print Name
_________________________________________________________________
Signature
Date
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