Rental Application
Rental Application Pay Stubs (include assistance programs)
DL, SS card
Separate application required from each applicant age 18 or older.
Date and time received by landlord _____________________________________
Credit check fee _____________________ Received by Madelyn _________________
|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 $_______________ |
|Security deposit paid by: __________________ |
|Credit check fee $_______________ |
|Other (specify): $_______________ |
|TOTAL $_______________ |
Applicant
Full Name—include all names you use (d): _________________________________
Home phone: _____________Work phone: ____________Cell phone____________
Email: ________________________ Social Security number: ________________
Driver's license number/state: __________________________________________
Other Identifying Information: ___________________________________________
Vehicle make: __________ Model: ___________ Color: ________ Year: _______
License plate number/state: _____________________________________________
NOTE: Tenant is responsible to pay PSE&G Gas, Heat, Air & Electricity. Additional Occupants
List everyone, including children, who will live with you: Please specify ages for children under 10 years old.
Full Name Relationship to Applicant
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
Rental History
First-time renters: attach a description of your housing situation for the past three years
Current address: _____________________________________________________
_____________________________________________________
Dates lived at address: ________________ Reason for leaving: ________________
Landlord/manager: ___________________ Landlord/manager's phone: __________
Rent: $_________________________ Security deposit: __________________
Previous Address: _____________________________________________________
_____________________________________________________
Dates lived at address: ________________ Reason for leaving: ________________
Landlord/manager: ___________________ Landlord/manager's phone: __________
Rent: $_________________________ Security deposit: __________________
Previous Address: _____________________________________________________
_____________________________________________________
Dates lived at address: ________________ Reason for leaving: ________________
Landlord/manager: ___________________ Landlord/manager's phone: __________
Rent: $_________________________ Security deposit: __________________
>>>>>>>>>>>>PLEASE PROVIDE ALL COPIES OF PAY STUBS>>>>>>>>>>
Employment History
Self-employed applicants: attach tax returns for the past two years
First applicant:
Name and Address of Current Employer:
Phone: ________________________________
Name of supervisor: ____________________ Supervisor's phone: _____________
Dates employed at this job: ______________ Position or title: _______________
Second applicant:
Name and Address of Current Employer: __________________________________
Phone: ________________________________
Name of supervisor: ____________________ Supervisor's phone: _____________
Dates employed at this job: ______________ Position or title: ________________
Attach pay stubs for the past year, from this employer or prior employers.
Income
1. Your gross monthly employment income (before deductions): $__________
2. Average monthly amounts of other income (specify sources): $__________
3. Spouse income $__________
4. Other subsidy $
5. Other assistance $
_____________________________________________________________________ TOTAL: $__________
Bank/Financial Accounts
| |Account Number |Bank/Institution |Branch |
|Savings Account: |________________ |________________ |________________ |
|Checking Account: |________________ |________________ |________________ |
|Money Market or Similar Account: |________________ |________________ |________________ |
Credit Card Accounts
Major Credit Card: [ ] VISA [ ] MC [ ] Discover Card [ ] Am Ex
[ ] Other: ____________________
Issuer: ________________________ Account No.: ________________________
Balance: $_________________ Average Monthly Payment: $____________________
Major Credit Card: [ ] VISA [ ] MC [ ] Discover Card [ ] Am Ex
[ ] Other: ____________________
Issuer: ________________________ Account No.: ________________________
Balance: $_________________ Average Monthly Payment: $____________________
Loans
|Type of Loan (mortgage, car |Name of Creditor |Account Number |Amount Owed |Monthly Payment |
|student loan etc. | | | | |
|____________ |____________ |____________ |$___________ |$____________ |
|____________ |____________ |____________ |$___________ |$____________ |
|____________ |____________ |____________ |$___________ |$____________ |
Other Major Obligations
|Type |Payee |Amount Owed |Monthly Payment |
|________________ |________________ |$_______________ |$________________ |
|________________ |________________ |$_______________ |$________________ |
|________________ |________________ |$_______________ |$________________ |
Miscellaneous
ABSOLUTELY NO PETS ALLOWED. Discuss with Landlord _____________________________________________________________________
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 How many times _____
Been sued? [ ] yes [ ] no How many times _____
Sued someone else? [ ] yes [ ] no How many times _____
Been evicted? [ ] yes [ ] no How many times _____
Been convicted of a [ ] yes [ ] no How many times _____
crime?
Explain any "yes" listed above: ___________________________________________
*References and Emergency Contact
Personal reference: _______________________ Relationship: __________________
Address: _______________________________
_______________________________
Phone: ____________________________
Personal reference: _______________________ Relationship: __________________
Address: _______________________________
_______________________________
Phone: ____________________________
Contact in Emergency: ____________________ Relationship: __________________
Address: _______________________________
_______________________________
Phone: ____________________________
Source
Where did you learn of this vacancy?
_____________________________________________________________________
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. I give permission for the landlord or its agent to obtain a consumer report about me for the purpose of this application, to ensure that I continue to meet the terms of the tenancy, for the collection and recovery of any financial obligations relating to my tenancy, or for any other permissible purpose.
__________________ ________________________________________________
Date Applicant
__________________ ________________________________________________
Date Applicant
Notes (Landlord/Manager):
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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