RESIDENTIAL RENTAL APPLICATION
(1 form per applicant)
THE PROPERTY
(TO BE COMPLETED BY LANDLORD)
Property Type: ☐ Apartment | ☐ Condominium | ☐ Home | ☐ Other: ____________________
Property Address: _____________________________________________________________
Beds (#): ____________ Baths (#): ____________ Square Feet (SF): _________________
Lease Type: ☐ Fixed term ☐ Periodic Lease Start Date: ______________ (mm/dd/yyyy)
Pets allowed? ☐ Yes ☐ No Smoking allowed? ☐ Yes ☐ No Parking? ☐ Yes ☐ No
Monthly Rent $___________________ Application Fee: $___________________
THE APPLICANT
Applicant’s Full Name: _______________________________ SSN: _____________________
Date of Birth: ______________ (mm/dd/yyyy) Phone Number: _______________________
E-Mail: _____________________________
Photo ID: ☐ Driver’s License ☐ Passport ☐ Other: ____________
ID#: ________________
Additional Occupant(s)? ☐ Yes ☐ No
If yes, describe: _________________________________________________________
Pet(s)? ☐ Yes ☐ No
If yes, describe: _______________________________________________________________
CURRENT RESIDENCE
Property Type: ☐ Apartment | ☐ Condominium | ☐ Home | ☐ Other: ____________________
Property Address: _____________________________________________________________
Monthly Rent ($): __________ Beds (#): ______ Baths (#): ______ Square Feet (SF): _______
Lease Start: ______________ (mm/dd/yyyy) Lease End: ______________ (mm/dd/yyyy)
Reason for Moving: ____________________________________________________________
Landlord’s Name: __________________________________
Landlord Email: _________________________ Landlord Phone: ________________________
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PREVIOUS RESIDENCE - 1
Property Type: ☐ Apartment | ☐ Condominium | ☐ Home | ☐ Other: ____________________
Property Address: _____________________________________________________________
Monthly Rent ($): __________ Beds (#): ______ Baths (#): ______ Square Feet (SF): _______
Lease Start: ______________ (mm/dd/yyyy) Lease End: ______________ (mm/dd/yyyy)
Reason for Moving: ____________________________________________________________
Landlord’s Name: __________________________________
Landlord Email: _________________________ Landlord Phone: ________________________
PREVIOUS RESIDENCE - 2
Property Type: ☐ Apartment | ☐ Condominium | ☐ Home | ☐ Other: ____________________
Property Address: _____________________________________________________________
Monthly Rent ($): __________ Beds (#): ______ Baths (#): ______ Square Feet (SF): _______
Lease Start: ______________ (mm/dd/yyyy) Lease End: ______________ (mm/dd/yyyy)
Reason for Moving: ____________________________________________________________
Landlord’s Name: __________________________________
Landlord Email: _________________________ Landlord Phone: ________________________
CURRENT EMPLOYER
Company Name: ______________________________________________________________
Employer’s Address: ___________________________________________________________
Title / Occupation: ________________________
Gross Monthly Income: $__________________ Start Date: ______________ (mm/dd/yyyy)
Supervisor Name: __________________________________
Supervisor Phone: _______________________ Supervisor Email: _______________________
PREVIOUS EMPLOYER
Company Name: _____________________________________________________________
Employer’s Address: ___________________________________________________________
Title / Occupation: ________________________
Gross Monthly Income: $__________________ For how long? __________ Months
Supervisor Name: __________________________________
Supervisor Phone: _______________________ Supervisor Email: _______________________
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VEHICLE(S)
Do you own a vehicle? ☐ Yes (describe below) ☐ No
Make: ________________________ Model: ________________________ Year: ___________
Color: _________________ Plate #: ___________________ State: ______________________
Do you own a second vehicle? ☐ Yes (describe below) ☐ No
Make: ________________________ Model: ________________________ Year: ___________
Color: _________________ Plate #: ___________________ State: ______________________
REFERENCES
Full Name: _____________________________ Relationship: __________________________
E-Mail: ________________________________ Phone: _______________________________
Full Name: _____________________________ Relationship: __________________________
E-Mail: ________________________________ Phone: _______________________________
Full Name: _____________________________ Relationship: __________________________
E-Mail: ________________________________ Phone: _______________________________
BACKGROUND INFORMATION
Have you ever been evicted or a defendant in an eviction action? ☐ Yes ☐ No
If yes, describe: _________________________________________________________
Have you ever filed, or are you in the process of filing bankruptcy? ☐ Yes ☐ No
If yes, describe: _________________________________________________________
Do you have any outstanding balances with past landlords? ☐ Yes ☐ No
If yes, describe: _________________________________________________________
Have you ever been asked to move for a lease violation of any kind? ☐ Yes ☐ No
If yes, describe: _________________________________________________________
Have you ever been convicted of a crime? ☐ Yes ☐ No
If yes, describe: _________________________________________________________
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CONSENT & ACKNOWLEDGMENT
I hereby certify that I am at least 18 years of age and that all information given on this
application is true and correct. I authorize the Landlord and its agents to obtain an investigative
consumer credit report including but not limited to credit history, OFAC search, landlord/tenant
court record search, criminal record search and registered sex offender search. I authorize the
release of information from previous or current landlords, employers, bank representatives, and
personal references. I agree to furnish additional credit and/or personal references upon
request. I understand incomplete or incorrect information provided in this application may cause
a delay in processing which may result in denial of tenancy. This investigation is for resident
screening purposes only and is strictly confidential. I hereby hold Landlord and its agents free
and harmless of any liability for any damages arising out of any improper use of this information.
Important information about your rights under the Fair Credit reporting Act:
• You have a right to request disclosure of the nature and scope of the investigation.
• You must be told if information in your file has been used against you.
• You have a right to know what is in your file, and this disclosure may be free.
• You have the right to ask for a credit score (there may be a fee for this service).
• You have the right to dispute incomplete or inaccurate information. Consumer reporting
agencies must correct inaccurate, incomplete, or unverifiable information.
Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania
Avenue N.W., Washington D.C. 20580.
In connection with my application for housing, I understand that the property owner/agent may
obtain one or more consumer reports, which may contain public information, for the purposes of
evaluating my application. These consumer reports will be obtained from one or more of the
following consumer reporting agencies:
• Equifax, E.C.I.F., P.O. Box 740241, Atlanta, GA, 30374-0241, (800) 685-1111
• Trans Union, Regional Disclosure Center, 1561 Orangethorpe Ave., Fullerton, CA,
92631, (714) 738-3800
• Experian (TRW), Consumer Assistance, P.O. Box 949, Allen, TX, 75002, (888) 397-
3742
These consumer reports are defined as investigative consumer reports. These reports may
contain information on my character, general reputation, personal characteristics and mode of
living. In connection with my application for housing, I authorize owner/agent to obtain a
consumer report from the consumer reporting agencies listed above.
Application Fee: $__________________
Applicant’s Signature: __________________________________ Date: ______________
Printed Name: __________________________________
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