Rental Application

Marital Status

Married

Single

Divorced

Separated

The undersigned hereby makes an application to rent property located at:

Anticipated move date of

Anticipated move date

at a monthly rent of $

Monthly rent

security deposit of $

Security deposit

due after application approval.

Should applicant back out of rental agreement, the security deposit will be NON REFUNDABLE

PLEASE TELL US ABOUT YOURSELF

Full Name:

Home Phone:

Other Phone:

Mailing Address:

Date of Birth:

Social Security #:

Driver’s license #:

State issued:

A criminal background check may be run. Is there anything negative you would like to comment on?

Co-Applicant Marital Status

Married

Single

Divorced

Separated

Co-Applicant Name:

Co-Applicant Phone:

Co-Applicant Date of Birth:

Co-Applicant SS#:

Co-Applicant Driver’s license #:

State issued:

Co-Applicant’s email:

A criminal background check may be run. Is there anything negative you would like to comment on?

Name of Dependents:

Dependents Age

Pets

Yes

List any Pets:

Type of Pet (dog/cat,etc)

Sex

Age

Neutered/Spayed (Yes/No)

How long have you owned?

Will any smokers occupy the property:

Yes

Do you have renter’s insurance?

Yes

Insurance Company

List any automobiles, trailers, motorcycles, etc to be stored at the property:

Make and Model:

License Plate #

Make and Model:

License Plate #

Make and Model:

License Plate #

Make and Model:

License Plate #

I/We hereby agree that no other person, persons or pets except those named herein will occupy the premises at any time without the consent of the owner or manager in writing.

RESIDENTIAL HISTORY (LAST 3 YEARS)

Current Address:

Apt #

City:

Month/Year Moved In:

Rent: $

Reasons for Leaving:

Owner/Agent:

Phone:

Previous Address (last 3 years)

Rent: $

Previous Address (last 3 years)

Rent: $

PLEASE DESCRIBE YOUR CREDIT HISTORY

Have you declared bankruptcy in the past seven (7) years?

Yes

Have you ever been evicted from a rental residence?

Yes

Have you had two or more late rental payments in the last year?

Yes

Have you ever willfully or intentionally refused to pay rent when due?

Yes

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Your Status

Full Time

Part Time

Student

Unemployed

Employer:

Dates Employed:

Dates Employed: (Finished Date)

Currently employed

Position:

Supervisor Name:

Phone:

Salary $

Salary

per

Salary rate

(If employed by above less than 12 months, give name & phone of previous employer or school:

Name & Phone

Co-Applicant’s employment information:

Your Status

Full Time

Part Time

Student

Unemployed

Employer:

Dates Employed:

Dates Employed: (Finish Date)

Currently employed

Position:

Supervisor Name:

Phone:

Salary $

Salary

per

Salary rate

(If employed by above less than 12 months, give name & phone of previous employer or school:

Name & Phone

PLEASE LIST YOUR REFERENCES

Banking Accounts:

Name

Type of Account

Name

Type of Account

Personal Reference or Emergency Contact:

Name

Phone:

Address:

Relationship:

I hereby apply to lease the above described premises. I warrant that all statements above set forth are true. However, should any statement made above be a misrepresentation or not a true statement of facts, this application will be disregarded. I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interview with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. Upon acceptance of this application,

I agree to deposit $

deposit amount

as the security deposit and to execute a lease for 12 months before possession is given. Should I back out of the rental agreement after security deposit has been given, this deposit will be NON REFUNDABLE.

accepted in

is not accepted in

business banking days,

shall be retained as part of the security deposit. The above information, to the best of my knowledge, is true and correct.

Please sign:

Name of Applicant / Date

Name of Co-Applicant / Date

AUTHORIZATION

Release of Information

I agree to permit an investigation of my credit/tenant history, banking and employment for the purposes of renting property with this owner/manager.

Name (please print)

Signature / Date

Additional comments

PLEASE TELL US ABOUT YOURSELF

List any automobiles, trailers, motorcycles, etc to be stored at the property:

RESIDENTIAL HISTORY (LAST 3 YEARS)

PLEASE DESCRIBE YOUR CREDIT HISTORY

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Co-Applicant’s employment information:

PLEASE LIST YOUR REFERENCES

Banking Accounts:

Personal Reference or Emergency Contact:

Please sign:

AUTHORIZATION

Release of Information

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