Form
Rental Questionnaire
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at this address?
Why are you moving?
Rental Preferences
Desired Move-In Date
-
Month
-
Day
Year
Date
Preferred Lease Term (12 months, 6 months, etc:)
Number of Occupants: (List all names and ages)
Do you have any pets? If yes, please specify type, breed, and weight:
Employment & Income
Current Employer:
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position/Title:
Monthly Income:
How long have you been employed here?
Supervisor's name and phone number:
Rental History
Current Landlord's Name & Phone:
Monthly Rent Amount:
Have you ever been evicted? (yes/no)
Have you ever broken a lease? (yes/no)
Do you have any late payments or past due balances with a previous landlord? (yes/no)
Background & Credit
Will you consent to a background and credit check? (yes/no)
Do you have any criminal history? (yes/no)
Approximate credit score (if known):
Additional Information
Vehicles (make/model/year):
Any special requests or questions?
Signature
Date
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: