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Rental Application

Personal Information
First and Last Name *
Email Address *
Date of Birth * 1/1/2001
SSN * 123-45-6789
Home Phone # * 123-456-7890
Cell Phone # * 123-456-7890
Work Phone # * 123-456-7890
Current Mailing Address * Your current mailing address, city, state, and zip.

Address you are interested in renting
Commencement date
Length term you are interested in renting
Interested rate/month

Reason you want to move
Total # of people to live with you
# of children to live with you


History of Residence
Current Residence
Address * Your current residing address, city, state, and zip.
Duration of residence here *
Own or Rent *
Monthly payment or rent *
Landlord's Name
Landlord's Phone #

Previous Residence
Address Your previous residing address, city, state, and zip.
Duration of residence here
Own or Rent
Monthly payment or rent
Landlord's Name
Landlord's Phone #


Employment Information
Current Employer
Company Name
Website
Supervisor's Name
Email
Phone #
Fax #
Mailing Address
Position
How long?
Pay
Annual Income

Previous Employer
Company Name
Website
Supervisor's Name
Email
Phone #
Fax #
Mailing Address
Position
How long?
Pay
Annual Income


Emergency Contact
Name
Relationship
Home Phone #
Cell Phone #
Work Phone #
Mailing Address


Co-applicant and/or Spouse Information
Name
Email
Date of Birth
Social Security Number
Home Phone #
Cell Phone #
Work Phone #

Current Residence
Address
Duration of residence here
Own or Rent
Monthly payment or rent
Landlord's Name
Landlord's Phone #

Previous Residence
Address
Duration of residence here
Own or Rent
Monthly payment or rent
Landlord's Name
Landlord's Phone #


Co-applicant Employment Information

Current Employer
Company Name
Website
Supervisor's Name
Email
Fax #
Phone #
Mailing Address
Position
How long?
Pay
Annual Income


Bank Information
Name
Branch
Phone #
Address
Checking Account #
Saving Account #


Credit References

Name/Phone/Address

Name/Phone/Address

Name/Phone/Address


Personal References

Name/Phone/Address

Name/Phone/Address

Name/Phone/Address


Other Information

Vehicle Information

Vehicle Information
Filed for bankruptcy?
If yes, when?
Served eviction or required to vacate? Been served an eviction notice or been asked to vacate a property you were renting?
If yes, when and why?
Refused to pay rent when due? Willfully or intentionally refused to pay rent when due?
If yes, when and why?



Landlord does not discriminate against any applicant on the basis of an illegal purpose including race, color, religion, sex, national origin, age disability, or family status. Such discrimination as the sole basis of refusal to rent is illegal throughout the United States. Local or State Laws may provide additional protected classes from discrimination. You can call the U.S. Department of Housing and Urban Development at 1-800-424-8590 to ask questions about discrimination.

I represent that the information provided in this Application is true and correct to the best of my knowledge.

I understand that this Application is not a rental agreement and that this Application does not create any obligation on the Landlord.

I understand that the information provided might be used by Landlord to determine whether to accept this Application. I authorize Landlord to verify all the information given in this application. Including banking and personal references and employment information provided.

I also authorize Landlord to perform a credit check and a criminal history check. I consent to the release of information relating to my credit and the information provided in this application.