Rental Application
Separate
application required from each applicant age 18 or older.
THIS SECTION TO BE COMPLETED BY LANDLORD
Address
of property to be rented: ___________________________________
______________________________________________________________
Rental term: [ ]
month-to-month [ ] lease from __________to _________
Amounts
Due Prior to Occupancy
First month’s rent $
____________
Security deposit $
____________
Credit check fee $
____________
Other:
__________________________ $
____________
TOTAL $ ____________
Applicant
Full
name--include all names you use(d): ___________________________________
Home phone:
___________________ Work phone: ___________________________
Social Security number:
______________ Driver’s license number/state: ___________
Vehicle
make: ______________ Model: ___________
Color: _________ Year: ________
License
plate number/state: ___________________________________
Additional
Occupants
List full names of everyone, including children,
who will live with you at least 50% of the time:
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Rental
History
Current
address: _______________________________________________________
Dates lived at address:
__________________ Reason for leaving:_________________
Landlord/manager:
___________________ Landlord/manager’s phone:_____________
Previous
address: _______________________________________________________
Dates lived at address:
_________________ Reason for leaving: __________________
Landlord/manager:
___________________ Landlord/manager’s phone: ____________
Previous
address: _______________________________________________________
Dates lived at address:
____________________ Reason for leaving: _______________
Landlord/manager:
___________________ Landlord/manager’s phone: _____________
Employment
History
Name
and address of current employer: ___________________________________
_____________________________________________________________________
Phone:
_____________________________
Name of supervisor:
_______________ Supervisor’s phone: ____________________
Dates employed at this
job: _______________ Position or title: __________________
Name
and address of previous employer: ___________________________________
________________________________
Phone: ______________________________
Name of supervisor:
_______________ Supervisor’s phone: ____________________
Dates employed at this
job: ______________ Position or title: ____________________
Income
1. Gross monthly
employment income (before deductions): $ ___________
2. Average monthly
amounts of other income (specify sources):
______________________________________________
$ ____________
Total: $ ____________
Credit
and Financial Information
Bank/Financial Accounts
Account Number
Bank/Institution
Branch
Savings
account:
__________________ ________________ ________________ _____________
Checking
account:
__________________ ________________ ________________ _____________
Certificate
of deposit account:
__________________ ________________ ________________ _____________
Money
market or similar account:
__________________ ________________ ________________ _____________
Mutual
fund or brokerage account:
__________________ ________________ ________________ _____________
Credit Accounts & Loans
(Auto loan, Visa, etc.)
Credit
card
______________________ __________ ____________
__________ ___________
Credit
card:
______________________ __________ ____________
__________ ___________
Loan
(specify type):
______________________
__________ ____________
__________ ___________
Other
major obligations:
______________________ __________ ____________
__________ ___________
Miscellaneous
Describe
the number and type of pets you want to have in the rental property:
______________________________________________________________________
Describe
water-filled furniture you want to have in the rental property:
______________________________________________________________________
Do
you smoke? [ ] yes [
] no
Have
you ever: Filed for bankruptcy? [
] yes [ ] no
Been sued? [ ]
yes [ ] no
Been evicted? [ ] yes
[ ] no Been convicted
of a crime? [ ] yes [
] no
Explain
any “yes” listed above:
References
and Emergency Contact
Personal reference:
_______________ Relationship: __________________________
Address:
___________________________ Phone: ___________________________
Personal reference:
______________________ Relationship: ___________________
Address:
__________________________ Phone: _____________________________
Emergency contact:
________________ Relationship: __________________________
Address:
____________________________ Phone: ____________________________
I
certify that all the information given above is true and correct and understand
that my lease or rental agreement may be terminated if I have made any material
false or incomplete statements in this application. I authorize verification of
the information provided in this application from my credit sources, current
and previous landlords and employers and personal references.
Signature
of applicant: _____________________________ Date: _____________
Notes
(Landlord/Manager):
_____________________________________________________________________
______________________________________________________________________