RENTAL APPLICATION
First Name Middle Last Birth Date Social Security # Driver’s License #
Any Other Names You’ve Used In The Past Home Phone Cell Phone
All Other Proposed Occupants Birth Date Relationship To Applicant
RENTAL/RESIDENCE HISTORY
Current Residence Previous Residence Prior Residence
Street Address
City
State & Zip
Last Rent Amount Paid
Owner/Manager and Phone
Number
Reason for leaving
Is/Was rent paid in full?
Did you give notice?
Were you asked to move?
Name(s) in which your
utilities are now billed:
From/To From/To From/To
Dates of Residency
EMPLOYMENT HISTORY
Current Employment Previous Employment Prior Employment
Employed By
Address
Employer’s Phone
Occupation
Name of Supervisor
Monthly Gross Pay
From/To From/To From/To
Dates of Employment
CREDIT HISTORY
Bank/Institution Name Balance On Deposit or Balance Owed
Savings Account
Checking Account
Credit Card
Auto Loan
VEHICLES (Include vehicles belonging to other proposed occupants also)
Make Model Color Year License Plate
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REFERENCES & EMERGENCY CONTACTS
Doctor Lawyer Nearest Relative Living Elsewhere
Name
Street Address
City
State & Zip
Phone Number
By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you.
Furthermore, if you abandon the apartment for any reason then you grant us permission to allow your relative listed above to remove all contents of
the dwelling on your behalf.
GENERAL INFORMATION
Have you ever been served a late rent Do any of the people who would be living How long do you think you would be
notice? in the apartment smoke? renting from us?
Have you ever filed for bankruptcy? If so, Have you ever been convicted of a
When would you be able to move in?
when? felony?
Have you ever been served an eviction notice? If so,
How many pets do you have (list Type, Breed, approx Weight & Age)?
when?
Have you had any reoccurring problems with your current apartment or landlord? If yes, please explain:
Why are you moving from your current address?
List any verifiable sources and amounts of income you wish to have considered (optional):
If you were to run into financial difficulty in the future and couldn’t come up with the money to pay the rent, do you know someone
that would loan you the money? If so, provide the person’s name, address, & phone # so that we can use them as a reference for
you.
Have you been a party to a lawsuit in the past? If yes, please explain why:
We may run a credit check and a criminal background check. Is there anything negative we will find that you want to comment on?
How did you hear about this apartment? Do you have an e-mail address we can reach you at?
Do you know of anybody else looking for an apartment? Please provide their name and number. If you refer a friend and you each
end up renting separate apartments from us then we will pay you a referral reward.
Agreement & Authorization Signature
The statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification
of information I provided and communication with any and all names listed on this application. I understand that any
discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for
an apartment and does not constitute a rental or lease agreement in whole or part. I further understand that there is a non-
refundable fee to cover the cost of processing my application and I am not entitled to a refund even if I don’t get the
apartment.
Signature: Date:
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