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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 or [ ] lease (from __________ to __________)

Amounts Due Prior to Occupancy

First month’s rent $ __________

Security deposit $ __________

Credit check fee $ __________

Other: _____________________ $ __________

TOTAL: $ __________

_________________________________________________________________________________________________________

THIS SECTION TO BE COMPLETED BY APPLICANT

Applicant Personal Information

Full name - include all names you use(d): _________________________________________________________

Home phone: ____________________ Work phone: ____________________

Social Security number: ____________________ Drivers 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 (if rental property):

___________________________________________

___________________________________________

Dates lived at this address: _____________________ Reason for leaving: ____________________________

Landlord/manager: ___________________________________ Landlord/manager’s phone: _____________

Previous address (if rental property):

___________________________________________

___________________________________________

Dates lived at this address: _____________________ Reason for leaving: ____________________________

Landlord/manager: ___________________________________ Landlord/manager’s phone: _____________

Previous address (if rental property):

___________________________________________

___________________________________________

Dates lived at this address: _____________________ Reason for leaving: ____________________________

Landlord/manager: ___________________________________ Landlord/manager’s phone: _____________

Employment History

Name of current employer: __________________________________________

Address:

___________________________________________

___________________________________________

Phone: _____________________________

Name of supervisor: ___________________________________ Supervisor’s phone: ______________________

Dates employed at this job: __________ to __________ Position or title: _____________________________

Name of previous employer: __________________________________________

Address:

___________________________________________

___________________________________________

Phone: _____________________________

Name of supervisor: ___________________________________ Supervisor’s phone: ______________________

Dates employed at this job: __________ to __________ Position or title: _____________________________

Income

Gross monthly employment income (before deductions):  $ _______________

Average monthly amounts of other income (specify sources): $ _______________

Sources: _____________________________________________________________________________

Total Income: $ ____________

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.):

                                                      Account            Name of                   Amount           Monthly

                                                      Number           Creditor                     Owed             Payment

Credit card: __________________ _____________________ ______________ ______________

Credit card: __________________ _____________________ ______________ ______________

 Loan (specify type): __________________ _____________________ ______________ ______________

Other major obligations: __________________ _____________________ ______________ ______________

 

Miscellaneous

Describe the number and type of pets (if any) you want to have in the rental property:

______________________________________________________________________________

____________________________________________________________________________________

Describe the water-filled furniture (if any) 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” answers from above:

 ___________________________________________________________________________________________________________________________________________________________

References and Emergency Contact

Personal reference 1: __________________________ Relationship: _____________________

Address: _______________________________________ Phone: ________________________

Personal reference 2: __________________________ 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): _____________________________________________________

____________________________________________________________________________________________________________________________________________________________

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