FREE Rental Application

MILLER APARTMENTS FREE Rental Application

Apply for rental with this online form. Red * are required
Personal Information
FULL NAME:*

First NameLast Name
Phone Number*

Area CodePhone Number
Social Security:*
xxx-xx-xxxx - Required Format
Phone (Copied)
Email Address:*
Birth Date:*

MonthDayYear
Drivers License #:*
Phone Number: *
(xxx) xxx-xxxx Required Format
Who else will be living with you? Please include all names and ages: *
Desired Move In Date
Date*

MonthDayYear
Date
Desired Property Address & Unit #:
Amount of Bedrooms Needed:*
Rental History

Please Include Your Last Two (2) Landlords & Addresses Rented
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Monthly Rent:*
Amount
Monthly Utilities:*
Amount
Landlord's Name
Landlord's Phone

Area CodePhone Number
Reason for Moving:
Date In:

MonthDayYear
Date
Date Out:

MonthDayYear
Date
Date In:

MonthDayYear
Date
Date Out:

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Monthly Rent:
Monthly Utilities
Landlord's Name
Landlord's Phone

Area CodePhone Number
Reason for Moving:
Employment Information
Current Employer:*
Position:*
Manager Name*
Manager Phone*

Area CodePhone Number
Monthly Income:*
How Much You Make Monthly BEFORE Taxes
Hire Date: *
Other Sources of Income with Explanation:
Amount Per Month:
Questionnaire

Please answer all these questions truthfully.
Do You Have Pets:*
Yes or No
How Many & What Type(s)?:*
Quantity of Pet(s) and Pet Breed(s)
Have You Ever Been Evicted?:*
Yes or No
If Yes, When & What Was The Reason?:*
Date / Reason
Have You Ever Been Convicted of A Misdemeanor?*
Yes or No
If Yes, When & What Was The Charge?*
Date / Charge
Have You Ever Been Convicted of A Felony?:*
Yes or No
If Yes, When & What Was The Charge?*
Date / Charge
Are You A Registered Sex Offender*
Yes or No
Emergency Contact Name:*
Emergency Contact Name
Emergency Contact Phone Number: *
Phone Number
Additional Information:
Vehicle Information
How Many Vehicles Do You Own:*
Enter a number: 0, 1, 2, 3
Vehicle Description (Make & Model):*
Make / Model
Vehicle Year & Color:*
Year / Color
License Plate (State & Number):*
License Plate / State
Social Security | SSI
Social Security Monthly Income:
Social Security Income
SSI Monthly Income:
SSI Income
Section 8
Total Amount Qualified For:
Rent Amount Qualified For:
Utilities Amount Qualified For:
Date You Qualify:

MonthDayYear
Date
For How Long:
Please read carefully and sign and date below if you agree. Applicant certifies that the information contained in this application is true and correct. Applicant understands that false or misleading information is grounds for immediate disqualification; furthermore, Applicant(s)/Tenant(s) will be responsible for any and all damage(s).
Authorization

Please review and submit your application
Applicant authorizes the Landlord or Landlord’s representatives to make any inquires deemed necessary to verify Applicant is the most qualified based on the below stated qualification standards. This verification includes, but is not limited to, direct contact with Applicant’s employers, current landlord, previous landlords, friends, personal and professional references, law enforcement agencies, government agencies, consumer reporting agencies, public records, eviction records, and any other sources of information which the Landlord or Landlord’s representative may deem necessary. Applicant verifies that the Landlord and Landlord’s representatives shall not be held liable for damages of any kind that result from the verification of the information provided. This authorization shall extend through Applicant’s tenancy to ensure continued compliance to the terms of tenancy or to recover any financial obligations relating to Applicant’s tenancy, and beyond the expiration of Applicant’s tenancy for recovery of any financial obligations, or for any other acceptable purpose. Should the Applicant be denied or face other adverse action based on information received in a consumer report, the Applicant has a right to obtain a free copy of the consumer report, and to dispute the accuracy of the information it contains by contacting the Consumer Reporting Agency.
Applicant authorizes release of all information to Landlord and agrees that the information provided in this rental application is true and correct. This authorization extends beyond the end of Applicant’s tenancy.
Signature:*

Clear
Should be Empty:

MILLER APARTMENTS FREE Rental Application

Personal Information

Desired Move In Date

Rental History

Employment Information

Questionnaire

Vehicle Information

Social Security | SSI

Section 8

Authorization