Utah Rental Application Form
[Note: Each adult applicant must fill out a separate application.]
Full Name of Applicant:
Phone No.:
Social Security No.:
Driver’s License No.:
State:
Birth Date:
Number of adults in your family?
Number of children?
Pets?
Applicant's e-mail address:
Present Address:
City:
State:
Zip:
How long at present address?
Landlord:
Phone No.:
Reason for moving:
Previous Address:
City:
State:
Zip:
How long at previous address?
Landlord:
Phone No.:
Reason for moving:
Employer:
Position:
Supervisor:
Phone No.:
How long?
Monthly gross income:
Name of Bank:
Checking Account No.
Savings Account No.
In Case of Emergency Please Notify: Name:
Relationship:
Address:
Phone No.:
Automobile No. 1 Make:
Model:
Year:
License No.:
Automobile No. 2 Make:
Model:
Year:
License No.:
Have you ever: Been evicted?
Been convicted of a felony?
Declared bankruptcy?
Been sued by a landlord?
Broken a rental agreement or lease?
I represent that the information contained in this application is true and complete to the best of my knowledge. I hereby auth orize,
verification, or reverification of any information contained in this application to be made at any time by the property owner, its agents,
successors, and assigns, either directly or through a credit reporting agency from any source named in this application. The property
owner will rely on information in this application, and I have a continuing obligation to amend and/or supplement this information
should it change at any time either before or during my tenancy. This application will be incorporated by reference as a part of my
rental agreement, and any false statement will be grounds for immediate termination of tenancy.
Signature of Applicant:____________________________________________________ Date:____________________