RESIDENTIAL RENTAL APPLICATION

Application Date: _____/_____/ ______

Equal Housing Opportunity

Property Address:______________________________________
APPLICANT INFORMATION

LEGAL NAME OF APPLICANT - FIRST

LAST

MIDDLE

CURRENT ADDRESS

DATE OF BIRTH

OCCUPATION- Full or Part Time

EMPLOYER

HOW LONG ON JOB

SS#

CITY

STATE and ZIP

MONTHLY INCOME HOME PHONE

CELL PHONE

EMPLOYER ADDRESS

EMPLOYER CONTACT NUMBER

IF MILITARY:
RANK________ YEARS OF SERVICE________ ETS________ DUTY PHONE__________________________________

IN CASE OF EMERGENCY:
CONTACT PERSON_____________________________________ RELATIONSHIP TO YOU____________________________ PHONE NUMBER___________________________
CURRENT LANDLORD

LANDLORD PHONE

CURRENT RENT

Email:

YEARS WITH LANDLORD

LEASE EXPIRATION DATE

PETS
WHAT KIND_______________________ HOW MANY____________ WHAT SIZE____________

CO-APPLICANT INFORMATION
(Must be filled out for every occupant 18 and over- even if married to applicant. Please ask for additional application if needed.)
NAME OF CO APPLICANT - FIRST
LAST
MIDDLE
SS#

CURRENT ADDRESS

DATE OF BIRTH

OCCUPATION- Full or Part Time

EMPLOYER

HOW LONG ON JOB

CITY

STATE and ZIP

MONTHLY INCOME HOME PHONE

CELL PHONE

EMPLOYER ADDRESS

EMPLOYER CONTACT NUMBER

IF MILITARY:
RANK________ YEARS OF SERVICE________ ETS________ DUTY PHONE__________________________________

IN CASE OF EMERGENCY:
CONTACT PERSON_____________________________________ RELATIONSHIP TO YOU____________________________ PHONE NUMBER___________________________
CURRENT LANDLORD

CURRENT RENT

LANDLORD PHONE

Email:

YEARS WITH LANDLORD

LEASE EXPIRATION DATE

PETS
WHAT KIND_______________________ HOW MANY____________ WHAT SIZE____________

APPLICANT'S RENTAL REFERENCES (OTHER THAN RELATIVES)

NAME

ADDRESS

PHONE NUMBER

FAX NUMBER

1.
2.

CO-APPLICANT'S RENTAL REFERENCES

NAME

ADDRESS

PHONE NUMBER

FAX NUMBER

1.
2.

APPLICANT'S BANK REFERENCES

NAME
CHECKING

ADDRESS

PHONE NUMBER

SAVINGS
CREDIT CARDS/OTHERS

Page 1 of 3

ACCOUNT NUMBER

RESIDENTIAL RENTAL APPLICATION

Equal Housing Opportunity

YOUR CREDIT HISTORY

Have you declared bankruptcy in the past seven (7) years?

Yes___________

No___________

Have you ever been evicted from a rental residence?

Yes___________

No___________

Have you had two or more late rental payments in the past year?

Yes___________

No___________

Have you or any household member been convicted of a felony or drug charges in the last five (5) years?

Yes___________

No___________

ADDITIONAL SOURCES OF INCOME

If you have other sources of income to consider, please list income, source, and person (banker, employer, etc.) whom we may contact. You do not have to reveal alimony, child
support, or spouse's annual income unless you want it considered in this application.
1.
3.
2.

4.

ADDITIONAL INFORMATION: Please provide any additional information that might be useful in evaluating your application.

NAMES OF OTHERS WHO WILL BE LIVING WITH YOU:

Name__________________________________________________________

Relationship__________________________________

Age_____________

Name__________________________________________________________

Relationship__________________________________

Age_____________

Name__________________________________________________________

Relationship__________________________________

Age_____________

NOTICES: I/WE hereby warrant that all information set forth above is true and correct and understand that this request may be denied if any information is
found to be incorrect. To verify the above statements, I/We direct those persons named in this application to answer questions about me or us. I/We waive all
rights of actions for consequences as a result of such information. I/We authorize and give permission to ________________________ to perform a credit
screening and nationwide criminal records search on me/us. I/We agree to pay $_______ (non-refundable) to the office in the form of check or money order
for each applicant and co-applicant for the credit check. I/We understand that a copy of my/our Driver's License will be copied and kept on file.

PLEASE DO NOT WRITE IN THIS BOX - FOR OFFICE USE ONLY

Credit Check Fee $_____________

Date:_________

Credit Report Requested Date:_____________

Office Notes:

Security Deposit $______________

Review Date:_________ by:_____________

Date:________
Approved Y___ N___

If the application is not approved or accepted by the owner or agent, the deposit will not be refunded, the applicant hereby waiving any claim for damages
by reason of non-acceptance which the owner or agent may reject. I recognize that as a part of your procedure for processing my application, an
investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be
acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living as permitted by state law.

APPLICANT SIGNATURE

DATE

CO-APPLICANT SIGNATURE

DATE

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RESIDENTIAL RENTAL APPLICATION

Equal Housing Opportunity

AUTHORIZATION
Release of Information
I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house,
apartment, or condominium from this owner, manager, brokerage, finder, agent or leasing company.

APPLICANT'S FULL NAME (PLEASE PRINT)

APPLICANT'S SIGNATURE

DATE

CO-APPLICANT'S FULL NAME (PLEASE PRINT)

CO-APPLICANT'S SIGNATURE

DATE

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