RENTAL APPLICATION

Full Name:

Date of Birth:

Spouse's Full Name (if applicable):

Date of Birth (if applicable):

Phone Number:

Email:

Rental History: (for the past two years, beginning with the most current):

Current Address

Current Rental Status:

How Long? (include dates):

Current Landlord/Manager Name:

Current Landlord/Manager Phone #:

Previous Address:

Previous Rental Status:

Previous Landlord/Manager Name:

Previous Landlord/Manager Phone Number:

Employment Information

Employment Status:

Current Employer:

Current Position:

Monthly Salary:

Annual Salary:

Supervisor's Name:

Supervisor's Telephone #:

If employed by the above less than 1 year, give name/contact, address and telephone of previous employer or school:

Spouse's Name (if applicable):

Spouse's Position

Spouse's Monthly Salary

Spouse's Annual Salary

Supervisor's Name:

Supervisor's Telephone:

If Spouse is employed less than 1 year, give name/contact, address and telephone of previous employer or school:

Other Income:

Source:

Name(s) of Occupants: (All Must be Listed) (Name/Date of Birth/Relationship)

Occupant 1:

Occupant 2:

Occupant 3:

Emergency Contact

Name:

Relationship:

Address:

Telephone #:

Bank:

City/State:

Checking Account #:

Credit Reference/Contact Name:

Telephone #:

Have You Ever?:

Filed for Bankruptcy:

YesNo

Been Evicted from a Tenancy:

YesNo

Willfully and Intentionally refused to pay rent when due:

YesNo

Please Include Any Additional Information, which might help management evaluate this application:

Pets:

Ownership of a Pet:

YesNo

Number of Pet(s):

12Other

Pet 1 Breed and Weight:

Pet 2 Breed and Weight:

Other Information

I/We certify under penalty of perjury that the information given here is true and correct.

We do business in accordance with the Fair Housing Act.

Signature of Applicant:

Signature of Spouse: