Rental Application

Rental Application

Equal Housing Opportunity
Anticipated move-in date of

MonthDayYear
Date
at a monthly rent of $
monthly utility fee of $
security deposit of $
pet deposit of $ (if applicable)
PLEASE TELL US ABOUT YOURSELF
Full Name
Social Security
Social Security
Email Address
example@example.com
Other Phone
Emergency Contact 1
Emergency Contact 2
Emergency Contact 3
CoApplicant Name
Social Security
Social Security
Email Address
example@example.com
Co-Applicant Other Phone
Emergency Contact 1
Emergency Contact 2
Emergency Contact 3
List All Pets
Do you or does anyone living with you smoke?

YesNo

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Month/Year Moved In
Month/Year Moved Out
Reasons for Leaving
Rent in Dollars
Owner/Agent
Phone Number
Please enter a valid phone number.
Previous Address 1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Month/Year Moved In
Month/Year Moved Out
Reasons for Leaving
Rent in Dollars
Owner/Agent
Phone Number
Please enter a valid phone number.
Previous Address 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Month/Year Moved In
Month/Year Moved Out
Reasons for Leaving
Rent in Dollars
Owner/Agent
Phone Number
Please enter a valid phone number.

Additional Information
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?
Daytime Phone Number
Please enter a valid phone number.
Nighttime Phone Number
Please enter a valid phone number.
I hereby apply to lease the above-described premises (the “Premises”) for the term and upon the conditions set forth in this application, and I acknowledge and agree that rent is payable the first day of each month, in advance. As an inducement to the owner of the property (“Owner”) and to Leasing agent as the leasing agent (“Agent”), to accept this application, I represent and warrant that all statements made in this application are true and correct; however, should any statement made in this application be untrue, incorrect or a misrepresentation of fact(s), I agree that my application will be denied and my Application Fee (defined below) will be retained by Agent to offset the agent's cost, time, and effort in processing my application.

I hereby deliver to Agent, $ Dollar amount as an application fee (“Application Fee”) in connection with my application to lease the Premises. Except as otherwise provided in this application, the Application Fee will be refunded to me if this application is not accepted by Owner within three (3) business days. Upon acceptance, the Application Fee shall be retained as part payment of the security deposit due under the lease for the Premises. If my application is so approved and accepted, within three (3) business days, I agree to execute a lease for the Premises for a term of Amount of months months before possession is given, using Owner’s standard lease form. I agree to pay the balance of the security deposit at the time I execute the lease. To the maximum extent permitted by law, if my application is not approved or accepted by Owner, I agree that the refund of the Application Fee will be my sole remedy, and I hereby waive any claim for damages by reason of non-acceptance of my application. If I withdraw my application for any reason, I agree that the Application Fee will be retained by Agent to offset Agent's cost, time, and effort in processing my application. Additionally, if I fail to execute a lease for the Premises using Owner’s standard lease form, within three (3) business days after acceptance of this application, I agree that the Application Fee will be retained by Agent to offset Agent's cost, time, and effort in processing my application.

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 mycharacter, general reputation, personal characteristics and mode of living.
The above information, to the best of my knowledge, is true and correct.

Clear

Authorization

Release of Information
Date

MonthDayYear
Date
I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house, apartment, or condominium from this owner/manager.
Full Name
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Rental Application

PLEASE TELL US ABOUT YOURSELF

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)

PLEASE DESCRIBE YOUR CREDIT HISTORY

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Co-Applicants Employment Information:

Additional Information

Authorization