Maine Rental Application Page 2
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1
2
3Job Title
Dates employed
Supervisor Name
Phone (
)
Monthly Pay: $
If you would like us to consider other sources of income for this Rental Application, please list the amount and the
person we may contact for confirmation. Please do not reveal alimony, child support, or anyone else’s income unless
you want us to consider it in this Rental Application.
Amount $_
___
Contact Name and phone number:
Co-Applicant’s Employment Status:
Full Time
Part Time
Student
_ Unemployed
Employer_
Address
Job Title
Dates employed
Supervisor Name
Phone (
)
Monthly Pay: $
If you would like us to consider other sources of income for this Rental Application, please list the amount and the
person we may contact for confirmation. Please do not reveal alimony, child support, or anyone else’s income unless
you want us to consider it in this Rental Application.
Amount: $
Contact Name and phone number:
RESIDENTIAL HISTORY FOR LAST 2 YEARS:
Current Address
Move In Date
Rent $_
Owner/Agent
_Phone (
)
Reason for Leaving
Previous Address
Move In Date
Move Out Date
Rent $
Owner/Agent
_Phone (
)
Reason for Leaving
CREDIT HISTORY:
☐
☐
Have you ever filed bankruptcy?
Yes
No
☐
☐
Have you ever been evicted from a rental residence?
Yes
No
☐
☐
Have you ever had a court order eviction?
Yes
No
☐
☐
Are you a party to any lawsuits?
Yes
No
☐
☐
Have you had any late rental payments in the last year?
Yes
No
☐
☐
Are there any judgments against you?
Yes
No
☐
☐
In the last five years, have you been convicted of any crimes?
Yes
No
If you answered yes to any of the above questions, please explain:
REFERENCES:
Bank References
Bank Name
Account Type
Account No.
Credit References
Name
Phone (
)
Name
Phone (
)
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