Rental Application and Receipt for Security Deposit
Property: _________________________________________ Name of Applicant: ____________________________________________________________________________ Social Security Number: ____________________ DOB:________ Driver’s License: _______________ State: ____ Spouse or Roommate: _________________________________________________________________________ Social Security Number: ____________________ DOB:________ Driver’s License: _______________ State: ____ Children’s names and ages: _____________________________________________________________________ Names of other occupants: ________________________________________ Relationship: __________________ Do you have pets? _________ Kinds: ____________________________________________________________ Present Address: _____________________________________________________________________________ Amount of rent: $__________________ How long: ___________________ Phone:_________________
Manager’s name: ________________________________ Manager’s phone: _______________________ Previous Address: ____________________________________________________________________________ Amount of rent: $____________________ How long: ____________________
Manager’s name: _________________________________ Manager’s phone: ______________________ Have you ever been evicted? _______ If yes, explain: ________________________________________________ Employment Information Employer: ____________________________________________________________________________ Address: ___________________________________________________ Phone:___________________ Monthly Salary: $_____________________________ How long: ______________________________
Re: Spouse or roommate Employer: ____________________________________________________________________________ Address: ___________________________________________________ Phone:___________________ Monthly Salary: $_____________________________ How long: ______________________________
Personal References: ________________________________________________ Phone: __________________ In case of emergency notify: ____________________________________ Relationship: ___________________ Address: ___________________________________________________ Phone: ________________________ I/we authorize release of any information needed by the owner/manager to verify the accuracy of the information above (including credit check/verification). I/we understand that if I/we do no comply with the terms of the lease, or fail to pay the rent, information may be turned over to a credit reporting agency. Only those listed above will occupy the premises. _______________________________________
Applicant Date
______________________________________
Applicant Date
Owner/manage acknowledges receipt of a security deposit in the amount of $________________ . Acceptance of the security deposit is contingent upon verification of the statements made above. ______________________________________
Owner/Manager Date