RENTAL APPLICATION
APPLICANT/S
First:
Applicants Last Name:
Drivers License Number :
MI
Birth date:
Social Security Number:
Email Address: ___________________________________________ Phone Number: ____________________________
Co Applicant Last Name:
First:
Drivers License Number:
MI
Birth date:
Social Security Number:
Email Address: _________________________________________Phone Number: ______________________________
Expected Move In Date:
Do you have any pets?
If so, how many?
Description of Pets:
Size of pet: _________lbs
RESIDENCE
Present Address / City / State:
How long?
Area-Code Phone:
Own/Rent/Other:
Name and Address of Current Landlord or Mortgage Company:
Area-Code Phone:
Monthly Rent/Payment:
Previous Address / City / State:
Previous Landlord Address:
Area-Code Phone:
How Long:
Have you ever been evicted:
EMPLOYMENT
Applicants Employer:
Supervisors Name:
How Long? ___________
Address:
Area-Code Phone Number:
Previous Employer:
Position:
Salary:
Supervisors Name:
Address:
Area-Code Phone Number:
Position:
Co Applicants Employer:
Salary:
Supervisors Name:
How Long?
Address:
Area-Code Phone Number:
Previous Employer:
Position:
Salary:
Supervisors Name:
Address:
Area-Code Phone Number:
Position:
Salary:
Additional Income: Child support, alimony, etc
Source:
Amount:
per:
VEHICLES
Number of Vehicles on Property:
Do you have any motor homes, vans, boats, or motorcycles? If so, specify:
Auto Number 1 Year/Make/Model:
License Plate:
State: ______
Auto Number 2 Year/Make/Model
License Plate:
State: ______
OCCUPANTS
Total Number of Occupants: _______
List Occupants with Birthdates:
__________________________
____________
___________________________ ______________
__________________________
____________
___________________________ ______________
EMERGENCY CONTACT
In Case of Emergency Call:
Area-Code Phone:
Relationship:
Address:
In the event of the rental application is approved, the owner or agent may apply the deposit of $
on account of security due or to become
due. If the application is approved and was not cancelled within 3 days (72 hours) but the undersigned chooses not to enter into the lease the deposit will be forfeited as
liquidated damages incurred by the owner as a result of not having been able to rent the apartment to another party during this time.
LEASE INFORMATION
Beginning Date:
Ending Date:
Size of Apartment:
Monthly Rental:
Yearly Rental:
Move In Date:
Pro Rate:
Security Deposit:
Balance due upon execution of lease by certified check or money order: $
Date:
I/We authorize the landlord to verify my credit record, employment, residences and other income references. I/We certify that I have
paid my mortgage/rent payment, have not broken a lease, and have not filed for bankruptcy within the past five (5) years. I/We
understand that the discovery of false information or negative credit or financial information will result in denial.
A non-refundable charge of $
will be retained for credit check purposes,
I/We authorize Lessor and/or SafeRent to verify the accuracy of all statements in this application. I/We authorize all employers,
landlords and creditors to release all information concerning the applicant for purposes of verifying this applicants ability to afford
the contractual obligations of this lease.
Applicant Signature:
Date:
Applicant Signature:
Date:
Resident Representative Signature:
Date:
