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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