Sample Rental Application
Company Name:
Address
Phone:
Fax:
Cell:
www.________.com
Note: Everyone over eighteen
(18) must complete a Rental Application Form
The unit applied for is located at __________________
Move in date___________________________________
At a monthly rental of $__________________________
An application fee of $_____________ has been accepted on_______
By:
Full Name____________________________________________________________
Phone: Home________________Work_______________Cell______________________
Email___________________________________________________________________
Date of birth __________
Social Security_________
Number and type of Pets._______ Weight__________
Total number of adults___________
Total number of children living with you under the age of 18_____________
(Not advisable in all states)
Residence History
Current Address_________________________________________________
Month & Year Moved_______________ Reason for leaving__________________________
Owner/Agent______________________________Phone______________________
Previous Address_________________________________________________
for leaving________________________
Owner/Agent______________________ Phone__________________
Previous Address (if within 3 years)____________________________________
Month & Year Moved________Reason for leaving:
Owner/Manager_____________________________Phone________________________
Please give your employment information
Employment History
Your Status: Employed Full-Time__________ Employed Part-Time_________
If you are a Student__________or Unemployed_____________________
List your Source of Income__________________________________________
Current Employer (Most Recent)________________________________
Phone___________________
Address___________________________________City____________State___
Date(s) Employed/From___________To____________ Position____________
Pre-tax Monthly Salary$___________ Household Monthly Income$__________
Previous Employer (Or Most Recent)_____________________________
Phone____________
Address___________________________________City____________State___
Date(s) Employed/From___________To____________ Position____________
Pre-tax Monthly Salary: $________
Household Monthly Income: $________
Other Income Sources_______________________________________________
_________________________________________________________________
Income: $_____________
Source: ___________________________________________________________
HAVE YOU EVER: Been sued for non-payment of rent?
Yes__No__
Been evicted or asked to move out?
Yes__No__
Broken a Rental Agreement or Lease?
Yes__No__
Been sued for damage to rental property?
Yes__No__
Declared bankruptcy?
Yes__No__
TOTAL NUMBER OF VEHICLES
Make/Model ________________________Year____License____________State___
Make/Model ________________________Year____License____________State___
IN CASE OF PERSONAL EMERGENCY, NOTIFY:
Full Address:
Relationship:
Home Phone:
Work Phone:
Cell:
NOTES:
In house use only
The application fee $____has been refunded by________on _______
Application is signed and dated________
Application is complete and is legible____
Photo ID and signature against the application checked? Date (
mmdy) initial_____
Prior landlord check. By phone_____Initial____Date_____
Remarks:
Employer verification by phone?____Initial____Date_____
Pay stubs Yes____ No_____ Initial____Date_____
Income Verification Form____
Initial____Date_____
Letter of intent to hire______
Initial____Date_____
Remarks:
Credit Check attached?____
Initial____Date_____
Remarks:
Accept______Deny_____
Appropriate letter sent to
applicant___
Initial____ Date______
Remarks:
I authorize and permit the property owner or manager to obtain
such credit reports, character reports, criminal reports as necessary.
I authorize you to contact previous landlords and present or previous
employers in order to verify rental and employment history as indicated
on this application. I further understand that false information,
incomplete or omitted information may be grounds of denial of tenancy
or subsequent eviction.
The information contained within this application is, to the best of my knowledge, is true and correct.
Signature of Applicant:
Date:
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