NOTE: A separate application is required for each applicant over the age of 18 (including dependent children) who will reside at the property. Please print clearly and complete all sections. Incomplete applications will not be processed.
Please Print or Type
Address of rental property:
Today’s date: ____/____/____ Desired move in date: ____/____/____ Desired length of occupancy? ______Years
Applicant's full legal name______Soc Sec #______/______/______
Driver’s License Number: ______State: ______
Date of birth ____/____/____ Birthplace: ______Mother’s Maiden Name:______
Other name(s) used within the last 3 yrs.______
Home phone #______Work phone #______Cell phone #______
Email address______
List Your Last Three Years Residence History & At Least Your Last Two Addresses (add pages as necessary)
Current address______City______State____ Zip______Type of property? ( 2 bedroom apartment, house, etc.) ______
How long at present address?______Occupancy dates______Current Rent/Payment $______
Landlord or Mortgage Company?______Phone #______
Loan # (if applicable)______Are Your Payments Current? Yes______No ______
Why are you moving?______
Former address: ______City______State______Zip______Type of property? ______
How long at former address?______Occupancy dates______Why moved?______
Former Landlord's Name______Phone :______
List Your Employment History For The Last Three Years (Please include titles or military ranks, etc. Note - you may be asked to substantiate your income with tax returns and/or other documentation if self employed.)(add pages as necessary)
Current Employer______How Long?______Phone #______
Address______City______State______Zip______
Position / Job description______Monthly gross pay $______Monthly take-home $______Superior's Name/Position______Phone #______
Former Employer______How Long?______Phone #______
Position / Job description______Monthly gross pay $______Monthly take-home $______Superior's Name/Position______Phone #______
List any additional monthly income (child support, SS, etc.) ______
List others who will be living with you:
Name Relationship Age Occupation
1.______
2.______
3.______
4.______
Please complete and sign the other side
List Nearest Relatives (for Emergency Contact and/or Reference)
Name Relationship Address Phone
1.______
2.______
List All Vehicles:
#1 Year ______Model ______# 2 Year ____ Model ______# 3 Year_____ Model ______
License No./State ______/______/______/____
List All Pets Which You Desire To Have Live On The Premises
Pet’s Name Type/Breed/Weight Sex/Neutered/Spayed
1.______
2.______
3.______
List Bank Accounts
Bank Name Account # Checking/Savings Approx. Balance
1.______
2.______
Credit References - Credit Cards & Loans What are your approximate scheduled monthly payments?
Owed To Balance Monthly Payment
1.______
2.______
3.______
List Two Personal References (Not related to you)
Name City/State Phone #
1.______
2.______
Learned Skills: ( ) Painting ( ) Carpentry ( ) Plumbing ( ) Other: ______
Please answer all questions
1. Have you ever been evicted? ( ) Yes ( ) No When : ______
2. Do you know of anything which might interrupt your income or ability to pay rent? ( ) Yes ( ) No
3. Rent is due in advance on the first of each month. Are you able to fulfill this requirement ( ) Yes ( ) No
4. Have you ever filed a petition of bankruptcy? ( ) Yes ( ) No When was it discharged? ______
5. Have you ever been sued? ( ) Yes ( ) No. On what basis
5. Have you or anyone in your household ever been convicted of a crime? ( ) Yes ( ) No
6. Are you obligated to pay child support or alimony? ( ) Yes ( ) No Amount $______
7. Do you plan to conduct any business in the house? ( ) Yes ( ) No If yes, what type of business? ______
Landlord and Landlord’s agents are hereby authorized to obtain credit reports, a vehicle operation history and criminal history on applicant using various state and private sources along with other public records available. Applicant understands and agrees that applicant will not receive copies of any credit reports obtained. Applicant authorizes present and past Landlords, Employers, Banks, Credit References, Personal References and any other person to release information regarding applicant's credit, rental, employment and/or criminal histories. A copy of this authorization may be accepted as an original. FAX TO: or MAIL TO:
Applicant's Signature: ______Date ___/___/___