TENANT APPLICATION FORM

PRE-TENANT APPLICATION FORM

Forestine Housing Solutions Information Form
Applicant History
Name*

First NameLast Name
E mail*
example@example.com
U Phone Number *
Please enter a valid phone number
Gender:*

MaleFemalePrefer not to Answer
Where is your current place of Residence *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Civil Status:*
Citizenship*
Proposed Occupants

Type N/A if only 1 Occupant
1.*

First NameLast Name
2.

First NameLast Name
Relationship
Target Date to Move In*

MonthDayYear
Does Applicant or any Proposed Occupant smoke?

YesNo
Do you own a pet? No Pets will be permitted in or around the properties. Will that be a problem?*

YesNo
If yes, number of pets and type:
Income Information

Funding
What is your past Employment History?*
Current Employer*
Business Address*
Business Telephone*
Please enter a valid phone number.
E-mail*
example@example.com
Do you receive Social Security Benefits Ex:SSI/SSD?*

YesNoBenefits “Pending”
What is your monthly income?*
Do you have family that live nearby? Do they support you financially?*
Do you have insurance?/Who is your insurance provider?*
Do you receive Medicaid?*

YesNo
Medical History

This is to better understand the medical needs of the potential occupant not a determination factor. Please be clear and concise.
Health Conditions/Medical Problems?*
Recent Hospitalizations:*
Have you been diagnosed with any Mental health problems? Symptoms?*
Type N/A if this question doesn’t apply
Have you ever received treatment? Under what circumstances? When and Where*
Do you take any medications? Please list all past and current medications.*
The Baker Act of 1971: allows for involuntary examination (what some call emergency or involuntary commitment), which can be initiated by judges, law enforcement officials, physicians, or mental health professionals and close friends and relatives. Have you been submitted for this Treatment?*
Personal Background Info
Have you ever been arrested, charged with a crime, or convicted?*

YesNo
Describe:
Have you been convicted of a felony?*

YesNo
Do you have a history of violent behavior or aggression? If yes, please describe the incident.*
Type N/A if necessary
Have you ever been charged with lascivious behavior? *
Type N/A if necessary
Rental History
Been evicted from a rental? *

YesNo
Defaulted on a lease?*

YesNo
Describe:
Personal Info
File Upload

Please upload IDs
Cancelof
In case of emergency, please notify:*

First NameLast Name
His/Her Address and Telephone number*
Relationship:*
Reason for relocation?*
Consent to Verification of Other Information
I warrant, to the best of my knowledge, all of the information provided in this Application is true, accurate, complete and correct as of the date of this Application. If any information provided by me is determined to be false, such false statement will be grounds for disapproval of my Application or termination of my Lease with Owner.

I understand and agree: (i) this is an application to rent only and does not guarantee that I will be offered the Property, and (ii) Lessor may accept more than one application for the Property and, using their sole discretion, will select the best qualified applicant. I hereby authorize the Lessor to verify the information provided.
Do you read this Agreement and agree to the terms and conditions*

YesNo
Where did you hear us?

FacebookOLXWalk InReferralOther
Primary Physician or Therapist?*
Should be Empty:

PRE-TENANT APPLICATION FORM

Applicant History

Proposed Occupants

Income Information

Medical History

Personal Background Info

Rental History

Personal Info

Consent to Verification of Other Information