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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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