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Slide 1: TENANT APPLICATION FORM Property Information Address: Rent $ Deposit $ Applicant History Applicant’ Full Name (Last, First, Middle Initial) s Jr/Sr Date of Birth Social Security Number Email: Drivers License # Phone # Phone # (Home) (Work) Name of Co-Applicants (Separate Application required for each Co-Applicant) (Last, First, Middle Initial) (Last, First, Middle Initial) (Last, First, Middle Initial) Applicant’ Present Address s Monthly Payment $ Present Landlord’ Name s Applicant’ Prior Address s Monthly Payment $ Prior Landlord’ Name s City [ ] Rent [ ] Own City Zip Dates: From - To [ ] Apartment [ ] House Zip Phone # Address City Zip [ ] Rent [ ] Own City Dates: From - To [ ] Apartment [ ] House Zip Phone # Address Proposed Occupants 1 - (Last, First, Middle Initial) 2 - (Last, First, Middle Initial) Date of Birth Date of Birth 3 - (Last, First, Middle Initial) 4 - (Last, First, Middle Initial) Date of Birth Date of Birth Does Applicant or any Proposed Occupant smoke? [ ] yes [ ] no Do you own a pet? [ ] yes [ ] no Number of pets: ______ Type: Employment Current Employer (if self-employed, name of business) Business Address Position Supervisor Type of Business Supervisor Phone Dates: From - To Other Income $ Source Monthly Income Prior Employer (if self-employed, name of business) Business Address Position Supervisor Type of Business Supervisor Phone Dates: From - To Other Income $ Source Monthly Income Financial Info Checking: bank and branch (include City/State) Savings: bank and branch (include City/State) Account # Account # Have you ever filed bankruptcy? [ ] yes [ ] no County/State where filed: What year? Have you or any proposed occupant ever: Been convicted of a felony? [ ] yes [ ] no Describe: __________________________________________________________________ Been evicted from a rental? [ ] yes [ ] no Describe: __________________________________________________________________ Defaulted on a lease? [ ] yes [ ] no Describe: __________________________________________________________________ Page 1 of 2
Slide 2: TENANT APPLICATION FORM ( continued ) Applicant Name Applicant’ Full Name (Last, First, Middle Initial) s Jr/Sr Personal Info In case of emergency, please notify: (local name, address & phone number) Auto Make Reason for relocation? Model Year Relationship: License # State Do you have renter’ insurance? [ ] yes [ ] no s Consent to Verification of Credit and Other Information I warrant, to the best of my knowledge, all of the information provided in this Application is true, accurate, complete and correct as of the date of this Application. If any information provided by me is determined to be false, such false statement will be grounds for disapproval of my Application or termination of my Lease with Owner. I understand and agree: (i) this is an application to rent only and does not guarantee that I will be offered the Property, and (ii) Landlord or Manager or Agent may accept more than one application for the Property and, using their sole discretion, will select the best qualified applicant. I hereby authorize the Landlord or Manager or Agent to verify the information provided and obtain a credit report on me. Applicant’ Signature: __________________________________________ s Date: _______________ Receipt for Application Screening Fee To Be Completed by Landlord, Manager or Agent Applicant has paid a nonrefundable screening fee of $_____________, applied as follows: $ _______ for credit reports, $________ for processing and verifying screening information (may include staff’ time s and related costs), and $______ for other out of pocket expenses. The Applicant has read the foregoing and acknowledges receipt of a copy: Applicant’ Signature: __________________________________________ s The undersigned has received the screening fee indicated above. Landlord, Manager, or Owner Signature: ___________________________________ Date: __________ Date: _______________ Page 2 of 2