Lease Application Form

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Rose Place Properties
LEASE APPLICATION FORM
ADDRESS OF RENTAL UNIT _____________________________________________________________________________________________________________
TODAY’S DATE ________________________________________________
MOVE IN DATE _____________________________________________________
RENTAL RATE $ _____________________________ PER WEEK/MONTH
SECURITY DEPOSIT $ ________________________________________________
TENANT INFORMATION
NAME ______________________________________________________________________
PHONE ______________________________________________
CURRENT ADDRESS __________________________________________________________
SOCIAL SECURITY NO. _________________________________
PERSONS OTHER THAN APPLICANT TO OCCUPY PREMISES _________________________________________________________________________________
YES
NO
ARE YOU A STUDENT? ___________ ___________
WHERE _____________________________________________________________________________
DO YOU OWN A CAR?
___________ ___________
LICENSE # ___________________________________________________________________________
DO YOU OWN A PET?
___________ ___________
NUMBER AND TYPE ___________________________________________________________________
RENTAL HISTORY
PLEASE GIVE THE FOLLOWING BACKGROUND INFORMATION AS TO YOUR LAST TWO PLACES OF RESIDENCE:
LANDLORD’S NAME AND PHONE
RENTAL ADDRESS
DATES OF TENANCY
(1) __________________________________________________________________________________________________________________________________
(2) __________________________________________________________________________________________________________________________________
CREDIT/FINANCIAL HISTORY
PRESENT EMPLOYER ________________________________________________________
PHONE ______________________________________________
POSITION _____________________________________________________ LENGTH OF EMPLOYMENT _____________________ TO ______________________
HAVE YOU EVER HAD A UTILITY BILL IN YOUR NAME? _________________
NAME OF COMPANY ______________________________________________
DATE OF SERVICE _____________________________
ADDRESS WHERE SERVICE WAS RECEIVED ______________________________________________
HAVE YOU EVER HAD A PHONE BILL IN YOUR NAME? __________________
NAME OF COMPANY ______________________________________________
DATE OF SERVICE _____________________________
ADDRESS WHERE SERVICE WAS RECEIVED ______________________________________________
BANK ACCOUNT(S):
CHECKING ______________________________________
BANKING _____________________________________________
NAME OF BANK _____________________________________
ADDRESS ____________________________________________________________
HOW MUCH MONEY DO YOU HAVE AVAILABLE MONTHLY FROM THESE SOURCES TO PAY FOR YOUR RENT?
JOB _______________________________ SOCIAL SECURITY _________________________________
SAVINGS _________________________________
ADC __________________________________ PARENTS ______________________________________
GA _____________________________________
GRANTS/LOANS ___________________________________ OTHER (DESCRIBE) _______________________________________________________________
Based upon the reply to these and other questions regarding a tenant’s level of personal responsibility, the landlord has the right to select the tenant(s)
best suited for the unit. I certify that the above information is accurate and complete. I authorize the verification of this information through a credit report
as well as references checks.
SIGNATURE _________________________________________________________________________________ DATE _____________________________________
A LANDLORD HAS THE RIGHT TO ASK FOR PROOF OF A TENANT’S ABILITY TO PAY RENT AND ASK FOR PAST RENTAL REFERENCES.

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