RENTAL APPLICATION FORM
TODAY’S DATE: ________________ ADDRESS APPLIED FOR:
_______________________________
APPLICANT’S INFORMATION
LAST NAME: _____________________ FIRST: _________________________ MI: _______
SS#: _______ DATE OF BIRTH: ________________________ PHONE#:______________________
PREVIOUS ADDRESS: __________________________________________________________________________
STREET CITY STATE ZIP
Landlord or Mortgage Co.: _____________ Phone (required): ________________ Rent Amount: ______
Reason for Leaving: ______________________________________________________________________________
Single or Married: ______________________
Proposed Occupants/Ages: 1) _______ 2) _______ 3) _______ 4) _______ 5) _______
Pet: ___________________________________ Vehicle: Type __________________ Smoker: Yes____ No ____
Earliest Possible Date of Deposit Payment: ___________________________________________________________
How much do you have at hand now to secure the property: ____________________________________________
Proposed Move-in Date: ______________________
EMPLOYMENT STATUS
Full Time: _____ Part Time: _____ Unemployed: _____ Student: _____ Retired: _____
Employed by: __________________________________ how long have you work there: ________________
Address: ______________________________________________________ Phone#: _______________________
Personal Reference: _____________________________________________ Phone#: ______________________
Applicant represents that all the above statements are true and correct and hereby authorizes verification of the above items
including, but not limited to, the obtaining of a credit report.
A refundable application fee of $100 should be settled on receiving this form.
Dated: ____________________ Applicant Signature: ____________________________
PLEASE TAKE A PICTURE OF YOUR ID AND ATTACH WHEN SENDING THE RENTAL
APPLICATION FORM FOR PROPER CHECKS THANK YOU FOR WORKING WITH US.
GOD BLESS YOU.