Application To Rent (Page 2 of 3) in pdf

BANK INFORMATION

Bank:

Branch:

Type of Account:

Bank:

Branch:

Type of Account:

REFERENCES

Emergency Contact

Ph: (

)

Name

Street address

City, State, Zip

Relationship

Next of Kin

Ph: (

)

Name

Street address

City, State, Zip

Relationship

Personal Reference

Ph: (

)

Name

Street address

City, State, Zip

Relationship

PERSONAL PROPERTY

Vehicle #1 Make:

Model:

Year:

License #

State:

Vehicle #2 Make:

Model:

Year:

License #

State:

Vehicle #3 Make:

Model:

Year:

License #

State:

Do you own any of the following?

Piano/Organ? Yes

Water-filled furniture? Yes

Fish Tank or Aquarium? Yes

If Yes, Size:

(Gallons)

PETS Please inquire about our pet policy (No cats or dogs)

Do you own any pets?

Yes

If yes, How Many?

(Include ALL PETS, even those kept in Aquarium, Terrarium or Cage).

Pet #1 Type:

Weight (pounds):

- or - Size (Length):

Pet #2 Type:

Weight (pounds):

- or - Size (Length):

Have your Pet(s) ever injured anyone, caused a disturbance, or damaged anything? Yes

If Yes, Please explain:

APPLICANT’S COMMENTS & EXPLANATIONS:

MEMBERS OF HOUSEHOLD

List ALL other persons to occupy the rental unit, for identification purposes, include their Age or Date of Birth

NAME

AGE or DOB

NAME

AGE or DOB

NAME

AGE or DOB

NAME

AGE or DOB

NAME

AGE or DOB

NAME

AGE or DOB

APPLICANT SCREENING CHARGE DISCLOSURES

Owner/Agent may obtain a tenant screening or credit report which generally consists of

credit history including credit standing;

public records, including but not limited to judgments, liens, evictions and status of collection accounts;

information verifications;

current obligations and credit ratings; and

criminal records

Owner/Agent is requiring payment of an Applicant Screening Charge of $20 PER APPLICANT, $20 PER CO-APPLICANT, $10 PER

GUARANTOR (CO-SIGNER), none of which is refundable unless the Owner/Agent does not screen the applicant. Application valid for up to two

weeks from date of receipt by Owner/Agent.

I understand I have the right to dispute the accuracy of any information provided to the Owner/Agent by a screening service or credit reporting agency. I

am aware that an incomplete application may cause delays or result in denial of tenancy. I certify the above information is correct and complete and by

signing below I hereby authorize you to make any inquiries you feel necessary to evaluate my tenancy and credit standing (including, but not limited to

credit reports, unlawful detainer (eviction) reports, bad check searches, social security number verification, fraud warnings, previous tenant history,

employment history & criminal records). If Owner/Agent is requiring payment of an applicant screening charge, applicant acknowledges receiving a copy

of Owner/Agent’s Screening Policies (Page 3 of this Form).

Signature (Required) ___________________________________________________________ Date _________________

Equal Housing Opportunity

Rev 7/14

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