New York Rental Application
PROPERTY APPLYING FOR:
________________________________________________
Personal Information
Full Name________________________ Birth Date____________ Social Security #_________________
Driver’s License # / State____________ Phone #_____________ Email__________________________
Roommates / Other Occupants
Full Name - First, Middle, Last Birth Date Relationship to You
Rental History
Please list your three most recent addresses or from past five years.
Current Address Previous Address Previous Address
Street Address / Unit No.
City, State, Zip
How long at this address
Manager/Owner Name
Manager/Owner Phone
Income
Please list employment from past five years & other sources of income.
Employment History
Current Employer Previous Employer Previous Employer
Employed by
Position
Dates of Employment (From..To)
Monthly Income
Name of Supervisor
Supervisor’s Phone #
Address - Street, City, State, Zip
Other Income Sources
Type Monthly Income Name of Provider Address - Street, City, State, Zip Phone #
Emergency Contact Information
Name ______________________ Phone # ______________ Relationship ___________________
Address - Street, City, State, Zip ____________________________________________________________
Vehicles
Make & Model Year Color Plate # State
Other Information
Have you ever been evicted? Yes No
If yes, when & why __________________________________________________________________________________________________
Have you ever been convicted of a felony? Yes No
If yes, when & why __________________________________________________________________________________________________
Have you ever filed for bankruptcy? Yes No
If yes, when & why __________________________________________________________________________________________________
Do you currently smoke? Yes No
Do you have any pets? Yes No
If Yes, please list each Type, Breed & Approx. Weight ___________________________________________________________
How did you learn about us? ______________________________________________________________________________________
Agreement & Consent to Background Check
I believe that the statements I have made are true and correct. I hereby authorize the verification of information I provided, communication with
any and all names listed on this application and for the issuer of this form to conduct a background check to obtain additional information on credit
history, criminal history and all Unlawful Detainers. I understand that any discrepancy or lack of information may result in the rejection of this
application. I understand that this is an application for a home or apartment and does not constitute a rental or lease agreement in whole or in
part. I further understand that there is a non-refundable fee to cover the cost of processing my application and I am not entitled to a refund.
Signature: _______________________________________ Date: ________________
CO-SIGNER
By signing this form, Co-signer authorizes the landlord to perform a credit check or background check, if necessary. Co-signer forms
are accepted at the landlord’s discretion, and a co-signer form does not in any way guarantee an applicant a rental unit. Failure to
fully complete a requested co-signer form may result in the landlord refusing a rental application.
Personal Information
Full Name ___________________ Birth Date _______________ Social Security # ________________
Driver’s License # / State ________________ Phone # _____________ Email ____________________
Current Employer Name / Phone # __________________________________________________________
Co-signing for
Full Name _______________________________ Unit Applied for __________________________________
It is hereby agreed that the aforementioned Co-signer will assume any and all responsibilities and/or obligations of the Leaseholder’s
share of expenses if the Leaseholder cannot or will not oblige. This Co-signer Agreement will remain in force throughout the entire
term of the Leaseholder’s tenancy, even if the tenancy is extended and/or changed in its terms.
Signature: ___________________________________ Date: __________________
