LOUISIANA RENTAL APPLICATION
Equal Housing Opportunity. Please Complete All Information Below.
Applicants Full Name
Phone #
DOB
Social Security #
Drivers License #
State
Exp.
Current Address
City
State
Zip
Current Landlords Name
Phone #
How long at this address
Reason for leaving
Previous Address
City
State
Zip
Previous Landlords Name
Phone #
How long at this address
Reason for leaving
Auto Yr
Make
Model
State/License Plate #
Employer
Position
Income
Employers Address
City
State
Phone #
How long at job
Other income/source
Do you allow smoking in the home? [ ] Yes [ ] No
Have you ever been evicted? [ ] Yes [ ] No
Have you ever been convicted? [ ] Yes [ ] No If Yes to any of these, you may explain on the reverse of application.
Preferred move-in date
Number and type of Pets
Name of bank
Branch
Type of Account
Name of bank
Branch
Type of Account
Personal References
Name
Yrs. Known
Relationship
Phone #
Name
Yrs. Known
Relationship
Phone #
Name
Yrs. Known
Relationship
Phone #
Total number of adults
, total number of children living with you under the age of 18
Names and relations of all other applicants
,
,
,
,
I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements
contained in this application for tenant screening as may be necessary in arriving at a tenant decision, I understand that the landlord
may terminate any rental agreement entered into for any misrepresentations made above.
Applicant Signature
Date
Landlord or Representative received from applicant a deposit of $
dollars, of which $
will be non-refundable and used
for application and tenant screening services. The balance will be applied to the remaining deposit due, or refunded if the applicant is
not approved.
Initial