Residential Lease Application Form

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Received on _________________ (date) at __________ (time)
RESIDENTIAL LEASE APPLICATION
Each occupant and co-applicant 18 years or older must submit a separate application.
Property Address:
Anticipated: Move-in Date:
Monthly Rent: $
Security Deposit: $
Applicant was referred to Landlord by:
Real estate agent
(
)
(
)
name
phone
Newspaper
Sign
Internet
Other
Applicant’s name (first, middle, last)
Is there a co-applicant?
yes
no
If yes, co-applicant must submit a separate application.
Applicant’s former last name (maiden or married)
E-mail
Home Phone
Work Phone
Mobile/Pager
Soc. Sec. No.
Driver License No.
in
(
)
state
Date of Birth
Height
Weight
Eye Color
Hair Color
Marital Status
Citizenship
(
)
country
Emergency Contact: Name:
Address:
Phone:
E-mail:
Name all other persons who will occupy the Property:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Name:
Relationship:
Age:
Applicant’s Current Address:
Apt. No.
(
)
city, state, zip
Landlord’s Name:
Email:
Phone:
__________________
_________________
__________________
________________
Day:
Nt:
Mb:
Fax:
Date Moved-In
Move-Out Date
Rent $
Reason for move:
Applicant’s Previous Address:
Apt. No.
(
)
city, state, zip
Previous Landlord’s Name:
Email:
Phone:
__________________
_________________
__________________
________________
Day:
Nt:
Mb:
Fax:
Date Moved-In
Date Moved-Out
Rent $
Reason for move:
Applicant’s Current Employer:
Address:
(
)
street, city, state, zip
Supervisor’s Name:
Phone:
Fax:
E-mail:
Start Date:
Gross Monthly Income: $
Position:
(TAR-2003) 10-16-07
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