Rental Application
ApplicantsInformation:
Name:__________________________________________________________________
Date of Birth:_______________ S.S.N._________________Phone:______________
Current Address:________________________________________________________
City:___________________State:______________ Zip Code____________
Own Rent (please circle) Monthly payment or rent:_________how long?__
Previous Address:________________________________________________________
City:_____________________ State:____________ZipCode____________
Owned rented (please circle) Monthly payment or rent:_____how long?___
Employment Information:
Current Employment:____________________________________________________
Employer Address:_________________________________ how long?____
Phone:___________E-Mail:_______________________Fax:____________
City:_____________ State:______________ ZipCode_______________
Position:__________ Hourly Salary (circle one) Annual Income_________
Emergency Contact:
Name of person not residing with you:______________________________
Address:________________________________________________________________
City:____________ State_______ Zip Code__________Phone___________
Relationship_____________________________________________________________
Co-applicant information, if married:
Name:__________________________________________________________________
Date of Birth:___________ S.S.N.__________________ Phone:__________
Current Address:________________________________________________________
City:______________________ State:______________Zip Code_________
Own Rent (please circle) Monthly payment or rent:_______how long?____
Previous Address:______________________________________________
City:_____________________ State:___________Zip Code____________
Owned rented (please circle) Monthly payment or rent:______how long?__
Co-applicant Employment Information:
Current Employment:____________________________________________
Employer Address:________________________________ how long?_____
Phone:__________E-Mail:__________________________ Fax:_________
City:_____________ State:___________________ Zip Code____________
Position:__________ Hourly Salary (circle one) Annual Income________
References
Name:__________________Address__________________________Phone________________
Name:__________________Address__________________________Phone________________
Name:__________________Address__________________________Phone________________
I authorize the verification of the information provided on this form as to my credit and employment. I have received a copy of this application.
Signature of applicant:________________________________Date:_________
Legal/ Criminal
Have you ever filed a petition for bankruptcy?_____YES OR NO
Have you ever been evicted from any tenancy or had an eviction notice served on you? ________ YES OR NO
Have you ever willfully and intentionally refused to pay any rent when due?________ YES OR NO
Have you been accused of, convicted of, plead guilty or “no contest” to a misdemeanor involving sexual misconduct? __________YES OR NO
I DECLARE THAT THE FOREGOING IS TRUE AND CORRECT. I AUTHORIZE THE VERIFICATION OF ALL FACTS CONTAINED HEREIN. FURTHERMORE, I AUTHORIZE THE OBTAINING OF A CREDIT REPORT AND A CRIMINAL HISTORY REPORT BEFORE, DURING, AND AFTER MY PROPOSED TENANCY.
OFFICE USE ONLY
Credit Score______# Of Open Collections:_______Open Liens:_____
Wage Garnishments:$________ Income Less Garnishments:$_______
Were the prior reference checks satisfactory (circle one) YES OR NO
Does the applicant have a criminal record: (circle one) YES OR NO
This applicant has been: (circle one) APPROVED OR DISAPPROVED
If disapproved, circle the reason: CREDIT RATING, INCOME, PAT REFERENCE
