RENTAL APPLICATION
Phone: (555) 555-5555 Email: landlord@yahoo.com
APPLICANT INFORMATION
FIRST NAME PRIMARY PHONE CELL HOME LAST NAME WORK PHONE DRIVERS LICENSE NUMBER MIDDLE INITIAL OTHER PHONE STATE BIRTH DATE
SOCIAL SECURITY NUMBER
-
-
How many proposed occupants including you will be residing in the room? Have all applicants applying viewed the interior of this room? * * Choose One * * Have you ever been evicted? * * Choose One * * Have you filed bankruptcy in the past 10 years? * * Choose One * * If yes, please explain: Have you ever been convicted of a felony? * * Choose One * * If yes, please explain: Will you have any waterbeds? * * Choose One * * (If yes, you must provide us with a copy of your insurance policy.) Will smokers live in the property? * * Choose One * * (Note: Smoking is not allowed in the house.) Will you have pet(s): * * Choose One * * (Note: No pets are allowed) If approved, what date could you move in? How many vehicles will be kept on the property, street and driveway? List all vehicles that will be kept at the property below:
YEAR MAKE MODEL COLOR STATE LICENSE#
List all proposed occupants that would live in the room below:
FULL NAME AGE BIRTH DATE
RENTAL HISTORY
CURRENT ADDRESS OWNER/MANAGER FROM: / / TO: / / CITY OWNER/MANAGER PHONE REASON FOR MOVING: STATE ZIP RENTAL AMOUNT $
EMPLOYEMENT HISTORY
PRESENT EMPLOYER DATE STARTED EMPLOYER PHONE# PREVIOUS EMPLOYER LENGTH OF EMPLOYMENT EMPLOYER PHONE# EMPLOYER ADDRESS POSITION/TITLE SUPERVISORS NAME PREVIOUS EMPLOYER ADDRESS POSITION/TITLE SUPERVISORS NAME
PERSONAL REFERENCE /EMERGENCY CONTACT
PERSONAL REFERENCE Full Name EMERGENCY CONTACT Full Name RELATIONSHIP RELATIONSHIP PHONE PHONE ADDRESS ADDRESS
RENTAL APPLICATION
Phone: (555) 555-5555 Email: landlord@yahoo.com BY SIGNING BELOW, APPLICANT UNDERSTANDS AND AGREES TO THE FOLLOWING: 1. I certify that all the information given above is true and correct. I hereby authorize Landlord listed above to verify any of the given information and to obtain character, criminal, employment, and rental information. Above listed Owners/Managers/Employers are herewith given express permission and consent to verify and confirm information provided to Landlord. I hereby hold all the above named parties, as well as Landlord free and harmless of any liability for providing written or verbal information and/or discussing the quality of my tenancy/employment with my prospective landlords in the future. I understand that my application will automatically be rejected if any of the information provided is not truthful. I understand that if I am approved, all rent and deposit monies due prior to occupancy must be paid in the form of a certified check or a cashiers check – no cash, money orders, or personal checks.
2.
3. 4.
Applicant Name Signature: _______________________________________________________________ Date:
________
* * * * * * * * * * * OFFICE USE ONLY * * * * * * * * * * * * * 1. ROOM DESIRED: Description of Room 2. Verification of Identification: Drivers license AND: Social Security Card Other: ____________ 3. All applicants have viewed Room: Yes No 4. Deposit fee paid: Yes No Amount Paid: $___________ Money Order Check# ____________ Date:_______ 5. Prepaid Rent Paid: Yes No Amount Paid: $___________ Money Order Check# ____________ Date:_______