Application Form

8-7-2023

HB23-1099: Portable Screening Report for Residential Leases (effective Aug. 7, 2023)

Requires landlords to accept a “portable tenant screening report” as part of the application process, in which case the landlord may not charge the prospective tenant an application fee. A portable tenant screening report includes information about the applicant from a consumer reporting agency, including the applicant’s:

Name;
Contact information;
Verification of employment and income;
Last-known address; and
Rental, credit, and criminal background histories, in compliance with Colorado law.
Landlords may require that the portable tenant screening report meet certain criteria, including that the report was:

Completed within the last 30 days;
Made directly available to the landlord by the consumer reporting agency or through a third-party website regularly engaged in the business of providing consumer reports, in compliance with all applicable consumer reporting laws;
Provided to the landlord at no cost; and
A statement from the prospective tenant that there has not been any material change in the information provided in the report.
Before taking any rental application for which the landlord would typically charge an application fee, landlords must advise applicants that they have a right to obtain a portable tenant screening report. Required language, timing, and placement of the advisement is included in the statute.

Landlords are exempt from these requirements if the landlord:

Does not accept more than one application fee at a time for a dwelling unit, or if a dwelling unit is rented to more than one occupant, does not accept more than one application fee at a time from each prospective tenant or tenant group for the dwelling unit; and
Refunds the total amount of the application fee to each prospective tenant within twenty calendar days after written communication from either the landlord or landlord’s agent or the prospective tenant declining to enter into a lease agreement for the dwelling unit.

Such information will be verified to include the person that is verfying the verified information. The process will require applicate to provide the detail and give the potential landlord 72 hours to verify.

Address of Property Applying for:*

Desired Term of Lease:*

Months

Desired Move-in Date*

Date

Monthly Rent $*

Security Deposit $*

Personal Information: Applicant

Applicant 1

Full Name*

First NameLast Name

Date of Birth*

Date

Social Security Number*

_ _ _ - _ _ - _ _ _ _

State of Birth*

DL Number*

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

E-mail*

Confirmation Emailexample@example.com

Applicant 2

Full Name

First NameLast Name

Date of Birth

Date

Social Security Number

_ _ _ - _ _ - _ _ _ _

State of Birth

DL Number

Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

E-mail

Confirmation Email

Applicant 3

Full Name

First NameLast Name

Date of Birth

Date

Social Security Number

_ _ _ - _ _ - _ _ _ _

State of Birth

DL Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

E-mail

Confirmation Emailexample@example.com

Rental History: Applicant

Most Recent Rental Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Landlord Name*

First NameLast Name

Landlord Phone*

Area CodePhone Number

Date Rented

From*

Date

To*

Date

Monthly Rent $*

Employment & Income: Applicant

Are you currently employed?*

YESNO

Current Employer*

Position / Title Held*

Start Date*

MonthDayYear

End Date*

MonthDayYear

Supervisor Name:*

Supervisor Phone*

Area CodePhone Number

Current Income $*

Monthly or Yearly*

If Military, Please list:

Branch:

Rank:

Base:

Unit #:

Commander Name:

Commander Phone

Area CodePhone Number

Personal Information: Co-Applicant

Full Name

First NameLast Name

Date of Birth

Date

Social Security Number

_ _ _ - _ _ - _ _ _ _

State of Birth

Dl Number

Current Street Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone

Area CodePhone Number

E-mail

Confirmation Emailexample@example.com

Rental History: Co-Applicant

Most Recent Rental Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Landlord Name:

Landlord Phone

Area CodePhone Number

Date Rented

From

Date

To

Date

Monthly Rent $

Employment & Income: Co-Applicant

Are you currently employed?

YESNO

Current Employer

Position / Title Held

Start Date

MonthDayYear

End Date

MonthDayYear

Supervisor Name:

Supervisor Phone

Area CodePhone Number

Current Income $

Monthly or Yearly

If Military, Please list:

Branch:

Rank:

Base:

Unit #:

Commander Name:

Commander Phone:

Area CodePhone Number

Pet Information (if applicable):

Do you wish to keep any pets on the property?

YESNO

You are responsible for knowing any pet restrictions for this property (breed, age, weight, etc).

There is a non-refundable pet fee of $300 per dog and $350 per cat.

Please list the pet information below:

Pet 1

Name:

Type:

Breed:

Age

Weight (lbs.)

Sex

MaleFemale

SpayedNeutered

Pet 2

Name:

Type:

Breed:

Age

Weight (lbs.)

Sex

MaleFemale

SpayedNeutered

Pet 3

Name:

Type:

Breed:

Age

Weight (lbs.)

Sex

MaleFemale

SpayedNeutered

Vehicle Information:

Please list all vehicles owned below:

Make:

Model:

Year:

Color:

Plate #

Make:

Model:

Year:

Color:

Plate #

Additional Residents:

How many people will be residing in the rental unit?

Provide their names and ages:

Name, Age

For any persons nunder the age of 18, Please state their relationship to the applicant(s):

Additional Information:

Does anyone in the household smoke?*

YESNO

Please note: Per the lease, ALL of our rental properties are smoke-free units.

Are you now or have you ever had eviction proceedings filed from any tenancy?*

YESNO

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

YESNO

Do you know of anything which may interrupt your income or ability to pay rent?*

YESNO

Rent is due on the 1st of each month. Are you able to fulfill this requirement?*

YESNO

Have you ever filed for a bankruptcy?*

YESNO

If so, please provide the date and location:*

Has anyone in the household ever been convicted of a felony or misdemeanor?*

YESNO

If so, please explain:*

Are you on any government subsidized housing?*

YESNO

If so, please provide your caseworker's name & phone number, as well as your allowance:*

Are you obligated to pay child support or alimony?*

YESNO

If so, how much per month?*

Type signature*

Date*

Date

Type signature*

Date*

Date

Type signature*

Date*

MonthDayYear