Rental Application

Previous Rental/Residence History
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Monthly Payment Amount
Move In Date

MonthDayYear
Move Out Date

MonthDayYear
Reason for vacating
Previous Landlord

First NameLast Name
Previous Landlord's Phone

Area CodePhone Number
Were you asked to leave?

YesNo
Did you ever receive a late notice

YesNo
Did you get your deposit back in full?

YesNo, landlord kept a portionNo, landlord kept entire deposit

Present Employment/Income Information
Current Employer
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Occupation
Length of Employment
Current salary range
Pay Stub (Optional but you may be asked to provide this later)

Upload a File

Cancelof
Do you have any other sources of income? Examples: government assistance, child support, etc... please list MONTHLY amount received

Criminal Record/History
Have you ever been convicted of a criminal offense?

YesNo
Have you ever been charged or convicted of a Felony?

YesNo
Have you ever been charged with a drug or alcohol related offense?

YesNo
Do you or any occupants (including minors) currently have a drug abuse problem?

YesNo
If you answered yes to any question in this section, please explain and include the date of the offense

Financial Information
Checking Account (1) Bank Name (2) Current Balance (3) Average Balance
Savings Account (1) Bank Name (2) Current Balance (3) Average Balance
Any other asset accounts if applicable (1) Bank Name (2) Current Balance (3) Average Balance
Do you have a Car Loan? if Yes, (1) current total balance (2) monthly payment (3) bank/lender name
Any other monthly expenses or obligations? Example: child support or other
Have you ever filed bankruptcy?

YesNo
How would you rate your credit?

General Information
Please list ALL vehicles to be stored at property (1) make/model/year (2) color (3) license plate
Any other info you would like to include
Legal Authorization to conduct a credit/background check, or otherwise verify the information you provided.
By typing your name below. You agree to the following terms.

I hereby authorize the property owners, it's employees, agents, and third parties (I.E. Cozy) to take any and all actions necessary to verify the contents of this application. I understand that such actions may include but are not limited to, a credit report, verification of employment, past rental history, police and criminal records, I will hold the property owner, it's employees, agents and third parties harmless from liability for the accurate reporting of such information to the management and/or owners. I also consent to allowing the property owner/manager/agents to use any information provided here to assist in debt collection activities if required. I certify that all information provided by me is true, correct, and complete and I understand that any misrepresentation or omission is caused for the management and/or owners to reject or decline this application and/or terminate any lease based on this application.
By Typing your name to the right you state that you have read and agree to the terms above.

Application Fee - If your application is approved, you will be asked to submit a non-refundable payment of $39.99 per adult for a formal background and credit report. You will receive a link via email once your application has been approved.
Today's Date

MonthDayYear
Should be Empty:

Application Fee - If your application is approved, you will be asked to submit a non-refundable payment of $39.99 per adult for a formal background and credit report. You will receive a link via email once your application has been approved.