Tenant Application Form

Date of Application

MonthDayYear

Target Date to Move In*

MonthDayYear

Location desired*

Type of unit desired (select all that apply)*

Applicants Full Name*

First NameMiddle NameLast Name

Birthdate*

MonthDayYear

Social Security Number*

Phone Number (including area code)*

E-mail address*

example@example.com

Driver's License Number*

Driver's License State*

Name

First NameMiddle NameLast Name

Date of Birth

MonthDayYear

Social Security Number

Relationship to You

Name

First NameMiddle NameLast Name

Date of Birth

MonthDayYear

Social Security Number

Relationship to You

Will there be anyone under 18 that would be residing with you?

YesNo

If yes, list their names & date of birth

Do you have any animals? *

YesNo

If yes, type and number of animals:

Present Address*

Street Address

Street Address Line 2

CityState

Zip Code

Date From

MonthDayYear

Date To

MonthDayYear

Reason for moving

Landlord/Mortgage Company

Landlord/Mortgage Company Phone Number

Previous Address*

Street Address

Street Address Line 2

CityState

Zip Code

Date From

MonthDayYear

Date To

MonthDayYear

Reason for moving

Landlord/Mortgage Company

Landlord/Mortgage Company Phone Number

Present Employer or Source of Income*

Phone Number

Please enter a valid phone number.

Employment Address

Street Address

Street Address Line 2

CityState

Zip Code

Gross Monthly Income

Date From

MonthDayYear

Date To

MonthDayYear

Current proof of income (2 different pay periods)*

Previous Employer*

Telephone*

Employment Address

Street Address

Street Address Line 2

CityState

Zip Code

Gross Monthly Income

Date From

MonthDayYear

Date To

MonthDayYear

Total Number of Vehicles*

Make/Model*

Year*

Color*

License Plate No./State*

Make/Model*

Year*

Color*

License Plate No./State*

Total Gross Monthly Household Income*

Amount $*

Per*

Source*

Telephone*

Amount $*

Per*

Source*

Telephone*

Comments

Contact #1: Full Name*

Relationship:*

Address*

Phone Number*

City*

State*

Zip Code*

Contact #2: Full Name*

Relationship:*

Address*

Phone Number*

City*

State*

Zip Code*

Have you ever been convicted, charged, plead guilty to, or plead 'no contest' to a felony, whether or not resulting in a conviction?*

YesNo

If yes, explain:

Have you ever been arrested, cited or charged with any criminal violations except minor traffic violations?*

YesNo

If yes, explain:

Have you ever been evicted, refused to pay rent, and/or had a Money Judgment issued against you because you owed a landlord or a person money after vacating their property?*

YesNo

If yes, explain:

In the past three years have you used an illegal &/or a controlled substance?*

YesNo

Has a landlord ever asked you to vacate their property?*

YesNo

If yes, explain:

Has your application been denied by another landlord within the past five years?*

YesNo

Have you ever had any issues involving bed bugs?*

YesNo

If yes, when:

In the last five years, have the police ever been called to your residence?*

YesNo

If yes, explain:

Have you ever filed bankruptcy?*

YesNo

If yes, explain

Current Government-issued ID*

Applicant’s signature on application authorizes management to check references including: Credit Report, Criminal checks, Income Verification, Employment and/or student verification, previous landlords or program participation, County Courthouse records for Small Claims filed, County Courthouse records for Money Judgments, Law enforcement with jurisdiction over previous address, others as deemed pertinent from Applicant.

Iowa Code Chapter 216, Iowa’s anti-discrimination law, DOES NOT AFFECT: 216.20 “Tenancy of an individual that would constitute a direct threat to the health and safety of other individuals or tenancy that would result in substantial physical damage to the property of others.”

Be advised that management will NOT: rent to persons who lie on their Applications, continue tenancy with persons who management later learns lied, rent to persons who have recent convictions for felonies and aggravated misdemeanors including any drug-related crimes and sex offenders, continue tenancy with persons who are currently convicted for felony and aggravated misdemeanor violations, rent to, or continue tenancy, with persons who entertain guests with recent convictions for felonies and aggravated misdemeanors, rent to persons with a history/ habit of poor credit, continue tenancy with persons who disregard provisions of the Rental Agreement or who cause property destruction or disturbances.

Management considers felonies and aggravated misdemeanors such as this list unacceptable behavior/ activity/ involvement for tenants of this property: assault/personal injury, prostitution, criminal mischief/ vandalism/property damage, arson or trespass, drug use/drug trafficking/drug manufacturing, child molestation/ endangerment/neglect/sex offenders, domestic violence, breaking and entering, theft/burglary/stolen property, illegal use of firearms/guns, stalking/kidnapping/rape/ sexual abuse.

I, the undersigned, do hereby authorize this company to verify my past and present: employment - position, length of time on job, school, or program participation, earnings/income, previous landlord references, past rental payment habits, information about past and present mortgages, confirm renters insurance, and compliance with previous landlords rental agreements.

And to obtain copies of my: credit report, small claims court history, criminal activities reports from state, county and/or agencies, probation or parole records and compliance, sex offender registry through the county, sheriff, or online.

Bed Bug and Crime Free Addendums must be signed by all residents prior to executing a lease with our company. Landlord can exercise their option to deny an application and/or terminate the lease if one and/or both of these addendums are not completed by the tenant(s).

This rental application must be filled out completely in order for management to correctly process it. This includes all addresses (including city, state, & zip code), phone numbers (including area codes), emergency contact information, etc. Any applications that are received and are missing information or areas are left blank will not or cannot be processed by management. Once the application has been filled out completely, management will start the verification process.

I have read over the application and filled it out to the best of my knowledge. I also understand that just because I have filled out the application, it does not mean that I am automatically approved. I authorize for management to verify this information.

Do you agree to the terms and conditions?*

YesNo

Fees

Application Fee

$45.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature*

Tenant Application Form

Personal Information

Other Residents (18 years of age & older)

Residence History

Employment Information

Other Information

Other Sources of Income

Emergency Contacts

Additional Information

Consent to Verification of Other Information