Rental Application
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Applicant
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Phone
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Social Security Number
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Address, City, State
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Co-Applicant
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Phone
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Social Security Number
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Address, City, State
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Child's Name, Age
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Child's Name, Age
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Child's Name, Age
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Acknowledgment:
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I understand that the property I am or may be looking at will continue to "be on the
market" until a deposit is put down and an acceptable reference check is
complete. If I put a deposit down on a property and my reference check is
acceptable, the property will be "taken off the market". My deposit will then be
non-refundable except for in the event that there is more than one acceptable
applicant with a deposit on said property and the Landlord chooses to sign a
RENTAL AGREEMENT with a party other than myself, in which case my deposit will
be returned to me in full. If I put a deposit down on a property and my references
are not acceptable, my deposit will be returned minus a $25.00 service charge.
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Marketing Information:
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Unit being applied for?
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Monthly Rent $
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Possession Date?
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Employment Information:
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Name of Employer
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Position
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Address
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Supervisor
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Phone
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Income Sources:
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Source 1
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Amount 1 $
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Source 2
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Amount 2 $
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Source 3
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Amount 3 $
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Screening Information:
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Have you ever been evicted?
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If yes, please explain:
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Are you currently addicted to,
distributing or ever been convicted
of using a controlled substance?
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If yes, please explain:
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Are you able to meet the requirements of
tenancy?
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If not, do you have someone who can help you?
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Relationship?
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Do you have a waterbed?
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References:
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We need at least two objective sources (preferably previous landlords)to confirm your
application and accept you as an eligible tenant.
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Previous Landlord
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Phone
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Address
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Dates you lived there? From
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Previous Landlord
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Phone
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Address
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Dates you lived there? From
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Other References:
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Name
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Phone:
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Relationship To You?
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Name
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Phone:
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Relationship To You?
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In case of emergency:
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Name of nearest relative:
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Phone:
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Vehicle: Make/Model and
License Plate Numbers:
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No persons other than those specifically named will be permitted to occupy the
dwelling without the written permission of the Landlord and an appropriate adjustment
in the rent. Acceptance of this application by the Landlord shall not constitute a
completed agreement to rent the premises. Both parties must also sign a formal
written RENTAL AGREEMENT. In the event the applicant refuses to sign an
agreement promptly, for any reason whatsoever, it is understood and agreed that any
deposit required for processing this application or any deposit to hold the unit shall be
forfeited to the Landlord.
The undersigned certifies that the above information is true and correct to the best of
my knowledge. I understand that this application may be checked for accuracy, that
my references and employer will be contacted, and that my income sources and
amounts may be verified.
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Signature of Co-Applicant:
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