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RENTAL APPLICATION
Equal Housing Opportunity
The undersigned
hereby makes an application to rent the following property:
____________________________________________________________________________________.
Anticipated move
date of ___________________at a monthly rent of
$_______________ and security deposit of $_______________.
| PLEASE TELL US ABOUT YOURSELF |
Full
Name__________________________________________________ Home
Phone ( ) ________________________
Date of Birth_________________________________ Social
Security #__________________________________________
Email Address:__________________________________________
Other Phone ( ) ___________________
Co-Applicant Name_________________________________________
Names of Dependents_________________________
Co-Applicant Date of Birth______________________ Social
Security #__________________________________________
Dependents Date of
Birth________________________________________________________________________________
List All
Pets__________________________________________________________________________________________
| PLEASE GIVE RESIDENTIAL HISTORY
(LAST 3 YEARS) |
Current
Address_______________________________Apt#________
City__________________ State______ Zip________
Month/Year Moved In______________________ Reasons for
Leaving____________________________Rent $__________
Owner/Agent__________________________________________________Phone
( ) ____________________________
Previous Address (last 3
years)_________________________________________________________Rent
$____________
Owner/Agent__________________________________________________Phone
( ) ____________________________
| PLEASE DESCRIBE YOUR CREDIT
HISTORY |
| Have you declared bankruptcy in the
past seven (7) years? |
Yes___________ No____________ |
| Have you ever been evicted from a
rental residence? |
Yes___________ No____________ |
| Have you had two or more late rental
payments in the past year? |
Yes___________ No____________ |
| Have you ever willfully or
intentionally refused to pay rent when due? |
Yes___________ No____________ |
| PLEASE PROVIDE YOUR EMPLOYMENT
INFORMATION |
Your Status: _____Full Time
_____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________________________
Dates employed_______________________________ Employed
as______________________________________________
Supervisor
Name______________________________________________ Phone
( )______________________________
Salary $_________________per________________. (If employed
by above less than 12 months, give name & phone of previous
employer or
school:________________________________________________________________________________.)
If you have other sources of income that you would like us
to consider, please list income, source, and person (banker,
employer, etc.) who we may contact for confirmation. You do
not have to reveal alimony, child support, or spouse's
annual income unless you want us to consider it in this
application.
Amount $___________________ Source/Contact
Name__________________________________________________________
| PLEASE LIST YOUR REFERENCES
|
Banking Accounts:
Name_________________ Type of Account_________________
Account Number_________________
Name_________________ Type of Account_________________
Account Number_________________
Personal Reference or Emergency Contact:
Name _______________________ Address
_______________________________________________
Phone _______________________
Relationship_______________________
Driver's License:
Your Driver's License Number_________________
State_________________
Vehicle Information:
Make / Model _________________Year _________________License
Plate State_________________
Please give any additional
information that might help owner/management evaluate this
application?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Where may we reach you to discuss this application?
Day Phone # ( ) ___________________________ Night
Phone # ( )____________________________
I hereby apply to lease the above described premises for the
term and upon the set conditions above set forth and agree
that the rental is to be payable the first day of each month
in advance. As an inducement to the owner of the property
and to the agent to accept this application. 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, all of the deposit will be retained to
offset the agent's cost, time, and effort in processing my
application.
I hereby deposit $___________ as earnest money to be
refunded to me if this application is not accepted in 3
business banking days. Upon acceptance, this deposit shall
be retained as part of the security deposit. When so
approved and accepted, I agree to execute a lease for
___________ months before possession is given and to pay the
balance of the security deposit prior to the move in date.
If the application is not approved or accepted by the owner
or agent, the deposit will be refunded, the application
hereby waiving any claim for damages by reason of
non-acceptance which the owner or agent may reject. 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
interviews with others with whom I may be acquainted. This
inquiry includes information as to my character, general
reputation, personal characteristics and mode of living.
The above information, to the best of my knowledge, is true
and correct.
Please sign: X__________________________________
__________________________________
Name of
Applicant
Date
AUTHORIZATION
Release of Information
I authorize an investigation
of my credit, tenant history, banking and employment for the
purposes of renting a house, apartment, or condominium from
this owner/manager.
_____________________________________________
Name (please print)
X_______________________________________
__________________________
Signature
Date
APPLICANT: PLEASE DO NOT WRITE BELOW (FOR OFFICE USE
ONLY)
Deposit of $__________________ Received by
____________________________ Date_______________
OFFICE NOTES:
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