RENTAL APPLICATION
Premises and Lease Information:
Address: ______
Description: ______
Parking: ______
Lease Start Date: ______Lease Term: ______
Monthly Rent: $______Security Deposit: $______
Application Fee: $______Number of Occupants: ______
Applicant Information:
Last Name______First Name______MI___
Date of Birth ______Social Security Number ______
Drivers License No.: ______
Home Phone: ______Work Phone: ______
Current Address: ______
Email Address: ______
Applicant Residency Information:
How long at this address?:______Monthly Rent?: $______
Reason for moving? ______
Owner/Manager/Landlord's name: ______
Owner/Manager/Landlord's phone: ______
Previous address: ______
How long at previous address?: ______Monthly Rent?: $______
Reason for moving? ______
Previous Owner/Manager/Landlord's name: ______
Previous Owner/Manager/Landlord's phone: ______
Have you ever been delinquent in paying rent in the last 3 years? ______
Name, relationship and age of every person that will be living with you:
Name Relationship Age
1.______2.______3.______4.______5.______6.______7.______8.______
Any pets? ______How many? ______What kind? ______
Will you be using a waterbed in the premises? ______
Employment Information:
Present Occupation: ______How long? ______
Current salary: $______(before deductions)
How are you paid? Weekly___ Bi-weekly___ Bi-monthly___ Monthly___
Employer's Name or Company Name: ______
Employer's Phone Number: ______
Supervisor's Name: ______
Supervisor's Phone Number: ______
Previous Occupation: ______How long? ______
Previous salary: $______(before deductions)
How were you paid? Weekly___ Bi-weekly___ Bi-monthly___ Monthly___
Employer's Name or Company Name: ______
Employer's Phone Number: ______
Supervisor's Name: ______
Supervisor's Phone Number: ______
If more than one person in the family is working what is the gross family income per month before deductions? $______
What amount of child support and or alimony do you pay per month? $______
What amount of child support and or alimony do you receive per month? $______
Financial Information:
Checking:
Bank Name: ______
Branch Location: ______
Checking Account #: ______
Savings:
Bank Name: ______
Branch Location: ______
Savings Account #: ______
Do you have a major credit card? _____ Account #: ______
Balance owed? $______Payment per month? $______
Credit Reference: ______Account #______
Balance owed: $______Payment per month: $______
Have you ever filed bankruptcy? ______When? ______
Have you been sued for unlawful detainer? ______
Have you ever been evicted? ______
Additional Information:
Vehicle(s): Make ______Model ______Year ______
Make ______Model ______Year ______
Personal Reference:
Name: ______
Address: ______
Phone: ______
Emergency Contact Information:
Name of person to be contacted: ______
Address: ______
Phone: ______
CONSENT TO OBTAIN CREDIT INFORMATION
As a material inducement to be considered as a tenant for the Premises, I herewith consent to and authorize______or any agent of same, to contact all references named in this application, and to conduct a credit review, including obtaining my credit report from any authorized credit reporting agency. I declare under penalty of perjury that the information listed in this application is true and correct.
Date______Signature ______
______
Application Deposit Receipt:
The $60.00 application fee is NONE refundable.
This deposit of $______is refundable upon the following conditions:
1. Prospective Optionee is not approved.
2. If approved, it may be applied to down payment of lease.
If the Prospective Optionee cancels after Optionor has taken the time, expense and trouble to check the tenant out, the deposit is NOT refunded; owner/agent will keep the deposit to pay for time and trouble.
Prospective Tenant ______
Landlord/Agent ______
(Date Refunded) ______
Prospective Tenant's Signature ______
Money Received $______