Sample Rental Application Company Name: Address Phone: Fax: Cell: www.________.com Note: Everyone over eighteen (18) must complete a Rental Application Form The unit applied for is located at __________________ Move in date___________________________________ At a monthly rental of $__________________________ An application fee of $_____________ has been accepted on_______ By: Full Name____________________________________________________________ Phone: Home________________Work_______________Cell______________________ Email___________________________________________________________________ Date of birth __________ Social Security_________ Number and type of Pets._______ Weight__________ Total number of adults___________ Total number of children living with you under the age of 18_____________ (Not advisable in all states) Residence History Current Address_________________________________________________ Month & Year Moved_______________ Reason for leaving__________________________ Owner/Agent______________________________Phone______________________ Previous Address_________________________________________________ for leaving________________________ Owner/Agent______________________ Phone__________________ Previous Address (if within 3 years)____________________________________ Month & Year Moved________Reason for leaving: Owner/Manager_____________________________Phone________________________ Please give your employment information Employment History Your Status: Employed Full-Time__________ Employed Part-Time_________ If you are a Student__________or Unemployed_____________________ List your Source of Income__________________________________________ Current Employer (Most Recent)________________________________ Phone___________________ Address___________________________________City____________State___ Date(s) Employed/From___________To____________ Position____________ Pre-tax Monthly Salary$___________ Household Monthly Income$__________ Previous Employer (Or Most Recent)_____________________________ Phone____________ Address___________________________________City____________State___ Date(s) Employed/From___________To____________ Position____________ Pre-tax Monthly Salary: $________ Household Monthly Income: $________ Other Income Sources_______________________________________________ _________________________________________________________________ Income: $_____________ Source: ___________________________________________________________ HAVE YOU EVER: Been sued for non-payment of rent? Yes__No__ Been evicted or asked to move out? Yes__No__ Broken a Rental Agreement or Lease? Yes__No__ Been sued for damage to rental property? Yes__No__ Declared bankruptcy? Yes__No__ TOTAL NUMBER OF VEHICLES Make/Model ________________________Year____License____________State___ Make/Model ________________________Year____License____________State___ IN CASE OF PERSONAL EMERGENCY, NOTIFY: Full Address: Relationship: Home Phone: Work Phone: Cell: NOTES: In house use only The application fee $____has been refunded by________on _______ Application is signed and dated________ Application is complete and is legible____ Photo ID and signature against the application checked? Date ( mmdy) initial_____ Prior landlord check. By phone_____Initial____Date_____ Remarks: Employer verification by phone?____Initial____Date_____ Pay stubs Yes____ No_____ Initial____Date_____ Income Verification Form____ Initial____Date_____ Letter of intent to hire______ Initial____Date_____ Remarks: Credit Check attached?____ Initial____Date_____ Remarks: Accept______Deny_____ Appropriate letter sent to applicant___ Initial____ Date______ Remarks: I authorize and permit the property owner or manager to obtain such credit reports, character reports, criminal reports as necessary. I authorize you to contact previous landlords and present or previous employers in order to verify rental and employment history as indicated on this application. I further understand that false information, incomplete or omitted information may be grounds of denial of tenancy or subsequent eviction. The information contained within this application is, to the best of my knowledge, is true and correct. Signature of Applicant: Date:
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