Rental Application

 

Separate application required from each applicant age 18 or older.

 

 

Application

Full Name-include all names you use(d):                                                                         

 

Home Phone: (     )                                         Work Phone (     )                                              

 

Cell Phone: (     )_______________________Birthdate:___________________________

 

Social Security Number:                      Driver’s License Number/State:                        

 

Vehicle Make:              Model:                         Color:                           Year:                           

 

License Plate Number/State:                                                                                                            

 

Additional Occupants

            List everyone, including children, who will live with you:

            Full Name                                                  Relationship to Applicant                               

 

                                                                                                                                               

 

                                                                                                                                               

 

                                                                                                                                               

 

                                                                                                                                               

 

Rental History

            Current Address:                                                                                                                     

           

Dates Lived at Address:                                  Reason for Leaving:                                              

           

Landlord/Manager:                                           Landlord/Manager’s Phone: (     )                

           

            Previous Address:                                                                                                                     

 

            Dates Lived at Address:                                  Reason for Leaving:                                              

 

            Landlord/Manager:                                           Landlord/Manager’s Phone: (     )                

 

            Previous Address:                                                                                                                     

 

Dates Lived at Address:                                  Reason for Leaving:                                                          

            Landlord/Manager:                                           Landlord/Manager’s Phone: (     )                

 

Employment History

 

Name and Address of Current Employer:                                                                               

 

                                                                        Phone: (     )                                                    

 

Name of Supervisor:                                           Supervisor’s Phone: (     )                            

 

Dates Employed at This Job:                              Position or Title:                                    

 

Name and Address of Previous Employer:                                                                               

 

                                                                                    Phone: (     )                                                    

 

            Name of Supervisor:                                           Supervisor’s Phone: (     )                            

 

            Dates Employed at This Job:                              Position or Title:                                    

 

Income

 

            1.  Your gross monthly employment income before deductions:                  $                     

 

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

 

                                                                                                                                                           

 

                                                                                                                                                           

 

            TOTAL:                                                                                                         $                     

 

Credit and Financial Information

 

            Bank Institution                                            Branch                                                            

 

Miscellaneous

 

            Describe the number and type of pets you want to have in the rental property:                     

 

                                                                                                                                                           

 

            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        

 

  Been sued? ___ yes ___ no

           

                                      Been evicted? ___ yes  ___ no

 

  Been convicted of a crime ___ yes ___ no           

 

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: (    )                                         

           

                                                                                                                                                           

 

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 false or incomplete statement in this application.  I authorize verification of the information provided in this application from my credit sources, credit bureaus, current and previous landlords and employers, and personal references.

 

                                                                                                                                                           

Date                                                                 Applicant

 

Notes (Landlord/Manager:)