We charge a $45 per person or $70 per married couple application fee for credit and criminal background check
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THIS SECTION FOR LANDLORD USE ONLY
Rental Property Address: ________________________________________________________________
Term of Rental: [ ] month to month [ ] lease from _____________ to ______________
Tenant Financial Obligation Prior to Occupancy CONTACT CHECKLIST
First Month's Rent: $____________________ Current Landlord Contacted - Timely Remittance
Security Deposit: $_____________________ [ ] Yes [ ] No
Pet Deposit: $_____________________ Current Employer Verified:
Application Fee: $_____________________ [ ] Yes [ ] No
Credit Report Fee: $_____________________ Credit Report Determination:
Other (specify): $_____________________ [ ] Yes [ ] No
Income Verified (pay stub, employer, etc.) [ ] Yes [ ] No
TOTAL: $_____________________
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DESIRED DATE OF MOVE-IN: ______ / _______ / 20_____
DESIRED LEASE TERM (check one): [ ] 12 months [ ] 6 months [ ] Other (Specify): ______
UNIT TYPE: [ ] 1 BR [ ] 2 BR [ ] 3 BR [ ] Other (Specify): ___________
APPLICANT INFORMATION:
Name (full legal name): ________________________________________________________________
Social Security Number: ____ ____ ____ - ____ ____ - ____ ____ ____ ____
DOB: _____ / _____ / _____
Home Phone: ____________________________ Work Phone: _______________________________
Driver's License / ID Number: _______________________________________ State: ____________
CO-APPLICANT INFORMATION:
Name (full legal name): ________________________________________________________________
Social Security Number: ____ ____ ____ - ____ ____ - ____ ____ ____ ____
DOB: _____ / _____ / _____
Home Phone: ____________________________ Work Phone: _______________________________
NAME OF OCCUPANTS AND RELATIONSHIP TO APPLICANT:
Name: ____________________________________________ Relationship: ___________________
Name: ____________________________________________ Relationship: __________________
Name: ____________________________________________ Relationship: __________________
APPLICANT / OCCUPANT VEHICLE(S):
Make: ___________________ Model: ____________ Year: _________ Tag#: _______________
Make: ___________________ Model: ____________ Year: _________ Tag#: _______________
Make: ___________________ Model: _____________Year: _________ Tag#: _______________
EMPLOYMENT HISTORY:
Current Employer:
Name and Address: ________________________________________________________________
Phone: ________________________________ Supervisor: ________________________________
Length of Employment:
Begin ________________ Still employed? (check one) ___ yes ___ no
Previous Employer
Name and Address: _________________________________________________________________
Phone: _____________________Supervisor: ____________________________________________
Length of Employment: Begin ______________ End ______________________
RENTAL HISTORY:
Current Address: __________________________________________________________
Dates Lived at This Address: From ________________ to __________________
Reason for leaving: ________________________________________________________
Landlord/Manager: _____________________________
Landlord/Manager's Phone: _____________________
Previous Address: ________________________________________________________
Dates Lived at This Address: From ________________ to __________________
Reason for leaving: _______________________________________________________
Landlord/Manager: _____________________________
Landlord/Manager's Phone: _____________________
Previous Address: ________________________________________________________
Dates Lived at This Address: From ________________ to __________________
Reason for leaving: _______________________________________________________
Landlord/Manager: _____________________________ Phone: __________________________
INCOME:
Gross Monthly Employment Income Before Deductions: $________________________
Gross Monthly Income From Other Sources (average): $________________________
TOTAL GROSS MONTHLY INCOME: $________________________
CREDIT and FINANCIAL INFORMATION: Bank and Financial Accounts
Checking:
Institution Name _________________________ Branch ____________________ Acct # ___________________
Savings:
Institution Name _________________________ Branch ____________________ Acct # ___________________
Credit Accounts
Credit Card: Type ______________ Amt Owed $__________________
Monthly Payment $_________________
Credit Card: Type ______________ Amt Owed $__________________
Monthly Payment $_________________
Vehicle Loan: Type of Vehicle: ________________________________
Monthly Payment $_________________
Vehicle Loan: Type of Vehicle: ________________________________
Monthly Payment $_________________
Other: Type _______________ Creditor _________________________
Monthly Payment $________________
MISCELLANEOUS: (check appropriate answer)
Do you have pets? _____ yes _____ no If so, describe
___________________________________________________________________________
NOTE: There may be additional fees and/or deposits required for pets housed on premises.
In addition, specific rules and regulations regarding pets may apply.
Do you smoke? _____ yes _____ no
Do you plan to have water filled furniture on the rental property? _____ yes _____ no
If yes, detail below.
______________________________________________________________________________
Have you ever been evicted? _____ yes _____ no If yes, explain below.
Have you ever been convicted of a felony? _____ yes _____ no If yes, explain below.
Have you ever filed for bankruptcy? _____ yes _____ no If yes, explain below.
Explanation:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
APPLICANT PERSONAL REFERENCES:
Name: _____________________________________________
Relationship: ____________________________
Address: ________________________________________________
Phone: ____________________________
Known this reference how long? _______________________
Name: _____________________________________________
Relationship: ____________________________
Address: ________________________________________________
Phone: ____________________________
Known this reference how long? _______________________
Name: _____________________________________________
Relationship: ____________________________
Address: _____________________________________________
Phone: ____________________________
Known this reference how long? _______________________
APPLICANT EMERGENCY CONTACT INFORMATION:
Contact in Emergency (Name): ___________________________________
Relationship:_____________________________ Phone:___________________________
I hereby certify and affirm that all information provided above is true and correct. I fully understand that my lease or rental
agreement may be terminated if I have made any false, misleading or incomplete statement(s) in this application. I
hereby authorize verification of all information provided in this application, including financial and credit information, via
credit bureaus and/or contact with current and previous employers, current and previous landlords and personal
references.
___________________________________________ _______________________________
APPLICANT DATE
__________________________________ ___ ____________________________
CO-APPLICANT DATE