APPLICATION TO RENT - Landlord
APPLICATION TO RENT
COPYRIGHT 2004 WWW.
Each Individual Occupant Who is Responsible for Rent Payment MUST Complete A Separate Application Form (California Residents 18 years or older Apply)
PERSONAL INFORMATION
LAST NAME
FIRST NAME
MIDDLE NAME
DATE OF BIRTH 1 PRESENT HOME ADDRESS
DRIVER'S LICENSE NO.
STATE EMAIL ADDRESS CITY
LENGTH OF TIME
STATE REASON FOR MOVING
LANDLORD NAME
2 PREVIOUS HOME ADDRESS
CITY
LENGTH OF TIME
STATE REASON FOR MOVING
LANDLORD NAME
3 NEXT PREVIOUS HOME ADDRESS LENGTH OF TIME
STATE REASON FOR MOVING
CITY LANDLORD NAME
PROPOSED OCCUPANT(S)
DESCRIBE EACH & EVERY PERSON WHO WILL OCCUPY THE PREMISES
FORM Courtesy of
SOCIAL SECURITY NUMBER
HOME PHONE NUMBER
(
)
STATE
ZIP CODE
LANDLORD PHONE NO.
(
)
STATE
ZIP CODE
LANDLORD PHONE NO.
(
)
STATE
ZIP CODE
LANDLORD PHONE NO.
(
)
WILL YOU HAVE ANY PETS? IF YES, PLEASE DESCRIBE
WILL YOU HAVE ANY LIQUID FILLED FURNITURE? IF YES, DESCRIBE
EMPLOYMENT/FINANCIAL INFORMATION
Present Occupation
How long with this Employer
Name of your Supervisor
Prior Occupation
How long with this Employer
Name of your Supervisor
Phone
number (
)
Phone
number (
)
Current Gross Income
$
PER
Week Month
Year
Name of your Bank
Employer Name Employer address
Employer Name Employer address
Branch or Address
Checking Savings
Account Number
Please List ALL of your Financial Obligations Name of Creditor
(If More Creditors Use Additional Sheet of Paper)
Address
COPYRIGHT 1999-2004 WWW.
Phone Number
(
)
(
)
(
)
(
)
(
)
(
)
Monthly Payment Amt.
(APPRENT2.PDF)
EMERGENCY/PERSONAL REFERENCE INFORMATION
IN CASE OF EMERGENCY, NOTIFY: 1.
ADDRESS
2.
MOTHER'S MAIDEN NAME:
PERSONAL REFERENCES 1 .
ADDRESS
2.
3.
PHONE PHONE
VEHICLE INFORMATION- (Please state exact number of motor vehicle that will be at the premises)
VEHICLE MAKE
MODEL
YEAR
VEHICLE MAKE
MODEL
YEAR
MOTORCYCLES (OTHER VEHICLES)
MODEL
YEAR
RELATIONSHIP
YEARS KNOWN
LICENSE NO. LICENSE NO. LICENSE NO.
Have you ever filed for bankruptcy?
IF YES, DATE BK FILED AND DESCRIBE:
Have you ever been evicted or asked to move?
IF YES, PLEASE DESCRIBE:
APPLICANT AUTHORIZATION
Applicant represents that all the above statements are true and correct and hereby authorizes landlord/agent to verify the above items including, but not limited to, the obtaining of a credit report and agrees to furnish additional credit references upon request. Landlord/Agent received a payment of $ which will be used to verify Applicant's credit history and other background information. The amount charged is itemized as follows:
1. Actual cost of credit report, including any eviction search, and/or other verifying reports:
$
2. Landlord/Agent cost to process and screen applicant's supplied information:
$
3. TOTAL FEE charged (not to exceed $30.00 per applicant (California Residents Only)):
$
The undersigned makes application to rent housing accommodations designated as:
Address of:
Apt. No.
City/State
the rental for which is $
per Month
Week
Other
and upon approval of this application agrees to sign a rental or lease
agreement and to pay all sums due, including required deposits, before occupancy.
Date
Signature of Applicant
COPYRIGHT 1999-2004 WWW.
APPRENT2.PDF
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