Equal Housing Opportunity

The undersigned hereby makes an application to rent the following property:*

Anticipated move-in date of*

at a monthly rent of $*

and security deposit of $*

+ pet deposit of $ (if applicable)

Full Name*

Home Phone:*

Social Security*

Email Address:*

example@example.com

Other Phone:

Emergency Contact #1*

Co-Applicant Name

Co-Applicant Home Phone:

Social Security

Email Address:

example@example.com

Co-Applicant Other Phone:

Emergency Contact #1

List All Pets

Do you or does anyone living with you smoke?*

NoYes

Current Address*

Apt#

City*

State*

Zip*

Month/Year Moved In*

Month/Year Moved Out*

Reasons for Leaving*

Rent*

Owner/Agent*

Phone: ( )*

Previous Address 1*

Apt

City*

State*

Zip*

Month/Year Moved In*

Month/Year Moved Out*

Reasons for Leaving*

Rent*

Owner/Agent*

Phone: ( )*

Previous Address 2*

Apt

City*

State*

Zip*

Month/Year Moved Out*

Reasons for Leaving*

Rent*

Owner/Agent*

Phone: ( )*

PLEASE DESCRIBE YOUR CREDIT HISTORY

Have you declared bankruptcy in the past seven (7) years?*

YesNo

Have you ever been evicted from a rental residence?*

YesNo

Have you had two or more late rental payments in the past year?*

YesNo

Have you ever willfully or intentionally refused to pay rent when due?*

YesNo

We will be running a credit check and a criminal background check. If there will be any negative items on these or from the questions above, please take this chance to explain the situation. Remember, we understand if you do have issues and it does not disqualify you from renting.*

Employment Status:*

Full TimePart TimeStudentUnemployed

Employer*

Dates employed from*

Dates employed to*

Employed as*

Supervisor Name*

Phone: ( )*

Salary*

per*

(If employed by above less than 12 months, give name & phone of previous employer or school:

If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application.

Amount

Per

Source/Contact Name

Your Status:

Full TimePart TimeStudentUnemployed

Employer

Dates employed from

Dates employed to

Employed as

Supervisor Name

Phone: ( )

Salary

per

(If employed by above less than 12 months, give name & phone of previous employer or school:

If you have other sources of income that you would like us to consider, please list income, source, and person banker, employer, etc who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application.

Amount

per

Source/Contact Name

List all past issues with your former residence so we can be sure these issues do not reoccur.

Where may we reach you to discuss this application?

Day Phone

Night Phone

I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared, whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living.

The above information, to the best of my knowledge, is true and correct.

Signature

Date

I hereby grant the above Apartment/Landlord/Realtor, whichever is applicable, and its designee the right to process this credit application for the purpose of obtaining a rental lease. In compliance with the FAIR CREDIT REPORTING ACT, this notice is to inform you that the processing of this application includes but is not limited to making inquiries deemed necessary to verify the accuracy of the information herein, including procuring consumer reports from consumer reporting agencies, obtaining credit information from other credit institutions and criminal background checks from appropriate law enforcement agencies. You have the right to make a written request within a reasonable period of time to receive additional information about the nature of this investigation. The undersigned agrees that this application shall remain the property of the apartment complex, landlord, realtor, regardless if rental lease is granted. The landlord also reserves the right to contact the above applicant by any means given over by applicant.

Name (please print)

Signature

Date

Please verify that you are human*

RENTAL APPLICATION

Equal Housing Opportunity

PLEASE TELL US ABOUT YOURSELF

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Co- Applicants Employment Information:

ADDITIONAL INFORMATION:

AUTHORIZATION - Release of Information