RENTAL APPLICATION FORM
Refundable Application Fee is $70 per Adult
The Landlord acknowledges the Confidentiality of this Document.
APPLICANT INFORMATION
Mr./Mrs./ Ms. Full Name
__________________________________________________ Today's Date
Home Phone ( ) _______________________ Email Contact (s)
_______________________
Driver's License # _______________________ issue ID and Expire date
____________
Make, Model of Car _______________________
Current Landlord's Name _______________________
How Long Have You Lived in the Residence __________
SSN _________________________________________
Date of Birth_________________________________
Other Phone ( ) ___________________
Current Address _______________________________Apt#________
City__________________ State______ Zip________
Reasons for Leaving ____________________________Rent $__________
Occupants ( List all occupants that would be staying in the house with you
1. _______________________ 2._______________________ 3.
_______________________
Home Address you are interested in moving to: ________
Are you married ____________________________
How many people will be living in the house ____________________________
Do you have a pet ___________________________
Do you have a car____________________________ Monthly income
_______________________
Occupation____________________________ Current Employer
_______________________ Location _______________________ Position
_______________________
How long do you want to rent this home _____________________
Move In Date___________________________
Do you have the payment with you _____________________
How soon can you make the payment _____________________
Reference Contact Name and Address if Any_____________________
Applicant Date of Occupancy: _____________ Desired Term of Lease ________
One copy of your passport photography if any!!!
NOTE: The proper maintenance of the house and good behavior is important to the
landlord
I hereby certify that information contained in this application form is true and correct to
the best of my knowledge. I agree to have any of the information checked by the
landlord. I authorize the references listed, as well as any other individuals whom the
landlord contacts to provide any and all information concerning my previous or current
residence and employment measures.
_______________________ _________
Applicant signature
Date