Rental Application

Equal Housing Opportunity

Please take a few extra moments to review your application before submitting it for processing

Please check to make sure we have complete information and phone numbers so we may expedite your application quickly.  Incomplete applications will delay processing.  Owner/Manager may require additional information.

The undersigned herby makes application to rent unit located at _____________________________ beginning on _______________ at a monthly rent of $______ and a security deposit of $________ and a utility deposit of $________.  Anticipated move-in date of _______________________.

PLEASE TELL US ABOUT YOURSELF

Full Name______________________________________________ Home Phone (         ) __________________

Date of Birth_______________________________ Social Security Number_____________________________

E-mail Address ____________________________________ Other Phone (         ) _______________________

Name of Co-Applicant _______________________________ Relationship _____________________________

Co-Applicant Date of Birth ___________________________ Social Security Number ____________________

Names and ages of Dependents________________________________________________________________

Please provide names of other tenants including children ___________________________________________

 _________________________________________________________________________________________

List all pets, breed, type, and size ______________________________________________________________

PLEASE GIVE RESIDENTIAL HISTORY (past 3 years, list current first)

Current Address __________________________________ City ____________________ State ____________

Month/Year moved in ________________ Reasons for leaving ________________________ Rent $________

Current Landlord/Agent ____________________________________ Phone (         ) ______________________

Previous Address (last 3 years) ___________________________________________ Rent $________________

Previous Owner/Agent _____________________________________ Phone (         ) ______________________

PLEASE GIVE YOUR EMPLOYMENT INFORMATION

Your Status                 Full Time                     Part Time                    Student                        Unemployed

Employer/School _______________________________ Address _____________________________________

Dates employed ________________________ Employed as _________________________________________

Supervisor Name ______________________________________ Phone (         ) _________________________

Salary $___________ per ____________ If employed by above less than 12 months, give name & phone of

Previous Employer/School _______________________________ Phone ______________________________

Co-applicant’s  Status                        Full Time                     Part Time                    Student                        Unemployed

Employer/School _______________________________ Address _____________________________________

Dates employed ________________________ Employed as _________________________________________

Supervisor Name ______________________________________ Phone (         ) _________________________

Salary $___________ per ____________ If employed by above less than 12 months, give name & phone of

Previous Employer/School _______________________________ Phone ______________________________

If there are other sources of income you would like us to consider, please list income, source, and person (banker, employer, etc) who we could contact for confirmation.  You do not have to reveal alimony, child support, or spouse’s annual income unless you want us to consider it in the application.

Amount $___________ Source/Contact Name _________________________ Phone (         ) _______________

Amount $___________ Source/Contact Name _________________________ Phone (         ) _______________

PLEASE LIST YOUR REFERENCES

Bank Accounts:

Name ___________________________ Type of Account ______________________ Acct No. ______________

Name ___________________________ Type of Account ______________________ Acct No. ______________

Credit References:

Credit Card Name ______________________________  Balance ___________ Monthly Payment __________

Credit Card Name ______________________________  Balance ___________ Monthly Payment __________

Vehicle Payments and other Payments:

Creditor Name _________________________________  Balance ___________ Monthly Payment __________

Creditor Name _________________________________  Balance ___________ Monthly Payment __________

Creditor Name _________________________________  Balance ___________ Monthly Payment __________

Personal References:

Name __________________ Address _________________ Phone _____________ Relationship ____________

Name __________________ Address _________________ Phone _____________ Relationship ____________

Emergency Contact:

Name __________________ Address _________________ Phone _____________ Relationship ____________

Your Driver’s License Number _____________________________________________ State _______________

Co-applicant’s Driver’s License Number _____________________________________ State _______________

Vehicle Information _________________________________________________________________________

                                    Make/Model                           Year                 License Plate                           State

Vehicle Information _________________________________________________________________________

                                    Make/Model                           Year                 License Plate                           State

HAVE YOU EVER

FILED FOR BANKRUPTCY?                                                                               YES                  NO

BEEN EVICTED FROM TENANCY OR BEEN IN A FORECLOSURE?                  YES                  NO

WILLFULLY OR INTENTIONALLY REFUSED TO PAY RENT WHEN DUE?          YES                  NO

Please give any additional information that might help the owner/management evaluate this application:

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance.  As an inducement to the owner of the property and to the agent to accept this application, I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of all facts, all of the deposit will be retained to offset the agent’s cost, time, and effort in processing my application

I hereby deposit $___________ as earnest money to be refunded to me if this application is not accepted within 3 business banking days.  Upon acceptance of this application, this deposit shall be retained as part of the security deposit.  IF YOU ARE ACCEPTED, THIS DEPOSIT IS NON-REFUNDABLE. When so approved and accepted, I agree to execute a lease for ___________ months and to pay the balance of the security deposit prior to the move in date.  If application is not approved and accepted by the owner or agent, the deposit will be refunded, the applicant hereby waiving any claim for damages by reason of non-acceptance which the owner or agent may reject.  I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted.  This inquiry includes information as to my character, general reputation, personal characteristics and mode of living.

THE ABOVE INFORMATION IS TRUE AND CORRECT.

Please sign X _______________________________________ ____________________________________

                                    Name of Applicant                                                                  Date

AUTHORIZATION

Release of Information

I agree to permit an investigation of my credit, tenant history, banking and employment for the purposes of renting this unit, and for the building owner/manager to provide our rental referral service your name and other required rental close out information.

_______________________________________________

Name (please print)

X______________________________________________ _________________________________

Signature                                                                                 Date

_______________________________________________

Co-signor Name (please print)

X______________________________________________ _________________________________

Co-signer Signature                                                                            Date

Office Use Only:

Deposit of $_________________ Received by: _______________________________ Date ________________