Rental Application

Rental Application

All Applicants over 18 years of age who will be on the lease must fill out a separate application. Applicant gives Shipley Homes LLC, Shipley Homes Team & our brokerage Cummings & Co Realtors permission to contact any of the persons or companies listed in this application. Proper consideration of the applicant can only be given in the event the application is completed in full. This application will be rejected if any of the information is found to be false. We adhere to all laws pertaining to fair housing.
Applicants Name*
Applicants Email*
example@example.com
If you are applying as a company, what is the company name the lease should be written in
If you are applying as a company, what is the company EIN
If you are applying as a company, what is the companys current address
If you are applying as a company, how long have you been in business
Your agents name if you have one
Email address of Agent if applicable
example@example.com
Your Present Address Including Zip Code*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address of Unit Applied For:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Monthly Rent *
Date of Occupancy*

MonthDayYear
Your Date of Birth*

MonthDayYear
Your Social Security Number*
Your Driver's License Number / State*
Cell Phone Number*

Area CodePhone Number
Work Phone Number

Area CodePhone Number
How Long at Present Address
Monthly Fee at Present Address
When Does your Current Lease Expire?

MonthDayYear
Current Landlord's Name*
Phone Number*

Area CodePhone Number
Other Tenants

Please list other persons who will occupy the dwelling unit to which you are applying. If other tenants are 18 years or older, they must be listed here and also must fill out a separate application.
Name

First NameLast Name
Email address (if 18 or older)
Name

First NameLast Name
Email address (if 18 or older)
Name

First NameLast Name
Email address (if 18 or older)
Name

First NameLast Name
Email address (if 18 or older)
Employment Information
You Are Employed By:*
How Long Have You Been with Your Current Employer?*
Address of Current Employer
Salary*
Current Position*
Name and Phone of Person to Verify Employment*
Monthly Net Income (after taxes, take home pay)*
Monthly Expenses
Rent or Mortgage
Student Loans
Utilities
Child Support
Other Expenses
Car Loan
Credit Cards
Total Monthly Expenses
Other Source of Income
Monthly Amount
Emergency Contact Information
In case of emergency, notify:*
Phone Number of Emergency Contact*

Area CodePhone Number
Address of Emergency Contact

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you or any other resident ever filed bankruptcy?

YesNo
Have you or any other resident ever been evicted from a tenancy?

YesNo
If applicant is denied for unit applied for, the background check fee will not be refunded to applicant.
CONSUMER REPORT AUTHORIZATION:I(we) authorize you to secure, from a consumer reporting agency, an investigative consumer report. This report may contain, but would not be limited to, a consumer credit report, a criminal history records investigation, verification of my residences, employment and income. I(we) authorize the consumer reporting agency, to verify any and all information contained in this application and to inquire into my character, general reputation, personal characteristics and mode of living, and I(we) release all concerned from any liability in connection with any information they give. I(we) have also been advised that I(we) have the right, under the Federal Fair Credit Reporting Act (FCRA), Section 606 (B), to make a written request of the consumer reporting agency, within a reasonable time, for a complete and accurate disclosure of the nature and scope of the investigation. I(we) acknowledge that I (we) may obtain from a consumer reporting agency, the summary of consumer rights required by Section 609 of the FCRA, entitled: A Summary of Your Rights Under the Fair Credit Reporting Act.
Signature *

Clear
Date*

MonthDayYear
Should be Empty:

Rental Application

Other Tenants

Employment Information

Monthly Expenses

Emergency Contact Information