Rental Application
Generally, people don’t actually fill out the “Credit and Financial Information” section.
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Separate application required from each applicant age 18 or older.
Applicant
Full Name – include all names you’ve used recently:
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| Home Phone(_____)____________________ | Work Phone(_____)_____________________ |
| Social Security Number: __________________ | Birth Date: |
| Driver’s License # & State:________________ | Vehicle Make: ______________ Model __________ |
| Color: ____________ Year: ______________ |
Additional Occupants
List everyone, including children, who will live with you:
Full Name Relationship to Applicant
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Rental History
Current Address: ________________________________________________________________________
| Dates Lived at Address: _____________________ | Reason for Leaving: ______________________ |
| Landlord/Manager: ________________________ | Landlord/Manager Phone: (_____)___________ |
Previous Address: _____________________________________________________________
| Dates Lived at Address: _____________________ | Reason for Leaving: ______________________ |
| Landlord/Manager: ________________________ | Landlord/Manager Phone: (_____)___________ |
Previous Address: _____________________________________________________________
| Dates Lived at Address: _____________________ | Reason for Leaving: ______________________ |
| Landlord/Manager: ________________________ | Landlord/Manager Phone: (_____)___________ |
Employment History
Name and Address of Current Employer: ___________________
| ______________________________________________ | Phone: (_____)____________________ |
| Name of Supervisor: _____________________________ | Supervisor’s Phone: (_____)__________ |
| Dates Employed at this job: ________________________ | Position / Title: ____________________ |
Name and Address of Previous Employer:___________________
| ______________________________________________ | Phone: (_____)____________________ |
| Name of Supervisor: ______________________________ | Supervisor’s Phone: (____)__________ |
| Dates Employed at this job: ___________________________ | Position / Title: ____________________ |
Income
| Your gross monthly employment income (before deductions): | $________________________ |
| Average monthly amounts of other income (specify sources): | $________________________ |
| Other _____________________________________ | $________________________ |
| Other _____________________________________ | $________________________ |
| Total: | $________________________ |
Credit and Financial Information
| Bank / Financial Accounts | Bank/Institution | Approximate Balance | |
| Savings Account | _____________________ | _____________ | __________________ |
| Checking Account | _____________________ | _____________ | __________________ |
| Other | _____________________ | _____________ | __________________ |
| Bank/Institution | Approximate Amount Owed | |
| Credit Card: | ______________ | ______________________ |
| Credit Card: | ______________ | ______________________ |
| Loan (car, student load, etc) | ______________ | ______________________ |
| Other:______________ | ______________ | ______________________ |
Miscellaneous
Describe the number and type of pets you want to have in the rental property:____________________
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Describe water filled furniture you want to have in the rental property:_____________________
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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: ____________________________________________
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References and Emergency Contact
| Personal Reference: ________________________ | Relationship: ________________________ |
| Phone: (_____)_______________________ | Phone: (_____)_______________________ |
| Personal Reference: ________________________ | Relationship: ________________________ |
| Phone: (_____)_______________________ | Phone: (_____)_______________________ |
| Emergency Contact: ________________________ | Relationship: ________________________ |
| Phone: (_____)_______________________ | Phone: (_____)_______________________ |
| Emergency Contact: ________________________ | Relationship: ________________________ |
| Phone: (_____)_______________________ | 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 / Maneger): __________________________________________________________
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