Residential Rental Application

Property Applied For

Property address *

Unit #

Desired move-in date

Monthly rent offered ($)

Lease term (months)

Applicant Information

Full legal name *

Date of birth

Social Security / ID no.

Driver's license / ID

State issued

Phone *

Email *

Government-issued photo ID will be provided? Yes No

Current Residence

Current address

Unit #

City

State

ZIP

Dates of residence

Monthly payment ($)

Do you rent or own? Rent Own

Landlord / mortgage holder

Landlord phone

Reason for leaving

Previous Residence (if at current address under 2 years)

Previous address

Unit #

City

State

ZIP

Dates of residence

Prior landlord phone

Employment & Income

Current employer

Position / title

Employer address

Supervisor

Work phone

Length of employment

Gross monthly income ($)

Other income source

Other monthly amount ($)

Other Occupants

List all additional people who will live in the unit, including minors.

Vehicles & Pets

Vehicle make / model

Year

License plate

Any pets? Yes No

Pet type / breed

Weight

# of pets

References & Emergency Contact

Personal reference name

Phone

Emergency contact name

Phone

Relationship

Background Disclosures

Have you ever been evicted? Yes No

Have you ever broken a lease? Yes No

Have you ever filed for bankruptcy? Yes No

Have you been convicted of a felony? Yes No

If you answered "Yes" to any of the above, please explain

Application Fee & Payment

Application fee per applicant

$50.00

# of applicants

Total due

$50.00

Payment method

Authorization & Signature

By submitting this application I certify that all information provided is true and complete. I authorize the landlord or their agent to verify the information above and to obtain consumer credit, rental history, employment, and background reports for the purpose of evaluating my tenancy. I understand the application fee is non-refundable and does not guarantee approval. I have read and acknowledge the state-specific notices shown at the top of this application.

I agree to the authorization above *

Type full name as signature *

Date *