RPM of Maryland Online Rental Application
Address being applied for:
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Date:
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First Name
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Middle Initial
Last Name
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Social Security Number
Date of Birth
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Cell phone Number
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Emergency Contact Number
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Email Address:
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Please upload a photo of your Drivers License or Identification Card
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Please upload a photo of your Social Security Card
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Rental History & Background:
Current rental address:
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Name of landlord
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Landlord Phone number:
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Years renting at this location:
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Total Rent Amount:
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If a voucher holder, voucher rental portion:
What is the reason you are looking to move?
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Current Rental Status
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Rows
Yes
No
N/A
Have you given your current landlord notice?
Do you currently owe any past rent to your current landlord?
Do you currently owe any money to BG&E?
Do you owe money towards your water bill?
Have you or Has Anyone in your Household *
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Rows
Yes
No
N/A
Filed for Bankruptcy?
Been Evicted?
Been a Party to Any Civil Law Suits?
Been to Rent Court?
Put your Rent in Rent Escrow?
Been Convicted of a Felony?
Please list the names and ages of all children or occupants that will be residing in the residence.
Do you Have Pets?
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Yes
No
If "Yes", list all with breed(s)?
Voucher Info: Answer Only if have a Voucher
Are a Voucher Holder?
Yes
No
Bedrooms
1
2
3
4
5
Which Program?
Section 8 City
Section 8 County
BRHP
Mayor's Office
Shelter Plus
Other
1st Time Voucher Holder
Yes
No
Employment Status/Income:
Current Job Position:
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Name of Company/Employer (if unemployed write "none")
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Company/Employer phone number (if unemployed write "none")
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Gross Monthly Income: (if unemployed write "none")
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Total years with this company (if unemployed write "none")
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Other sources of income: Please list SSI, TCA, Foodstamps, Disability, other family member income, or any other sources you may benefit from. Include total dollar amount.
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If you are not a voucher holder, please upload a photo of two recent Pay Stubs.
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Signature Required for Form to be accepted and processed. By signing you agree that you are legally the individual applying and that all the information is correct to the best of your knowledge. By agreeing to submit this application it is understood that RPM of Maryland can conduct a background check based on the information provided to approve qualified applicants.
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