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Rental Application

SEPARATE PPLICATION A REQUIRED FROMEACHAPPLICANT AGE 18OROLDER _ Credit Check Fee

Date and time received by landlord

Received __

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This section to be completed by landlord Address of Property to Be Rented: Rental Term: [ ] month to month [ ] lease from Amounts Due Prior to Occupancy: First month's rent$ Security deposit Credit-check fee Other (specify): TOTAL: Applicant Full Name-include all names you use(d): Home Phone: Work Phone: Email: Social Security Number: Other Identifying Information: Vehicle Make: License Plate Number/State: Model:
$, $,__ $, ----,,

_ to _
_ _ _

_ Cell Phone: FAX: Driver's License Number/State: ----, __ Color: _ _ _ _ Year: -----_

(by providing this fax number I agree to receive facsimile advertisements from the landlord or management company.)

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Additional Occupants: List everyone, including children, who will live with you. Full Name Relationship to Applicant

Rental History: First-time renters: attach a description of your housing situation for the past five years. Current Address: Dates Lived at Address: Reason for Leaving: Landlord/Manager's Phone: Previous Address: Reason for Leaving: LandlordIManager's Phone: Previous Address: Reason for Leaving: LandlordIManager's Phone: Name and Address of Current Employer: Phone: Dates Employed at This Job: Name and Address of Previous Employer: Phone: Dates Employed at This Job: Name of Supervisor: Position or Title:
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LandlordIManager: Rent: $ Security Deposit: $

Dates Lived at Address: -----------LandlordIManager: _ Rent: $ Security Deposit: $

_

Dates Lived at Address: -----------LandlordIManager: _ Rent: $ '--Supervisor'sPhone: Position or Title: ~ Supervisor's Phone: _
LF213P Rental Application 1008

Security Deposit: $

Employment History: Self-employed applicants: attach tax returns for the past two years. _ _ _ _ _ Name of Supervisor:

Attach pay stubs for the past two years, from this employer or prior employers,

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Income: 1. Your gross monthly employment income (before deductions):

2. Average monthly amounts of other income (specify sources): ____________________________________ ~~

$----------------TOTAL: $ Branch

$-----------------_

Bank/Financial Accounts
Savings Account Checking Account . Money Market or Similar Account

Account Number

Bankllnstitution

_ Balance: $ Average Monthly Payment: $ Balance: $ Average Monthly Payment: $ Account Number Amount Owed
_ _
_

Credit Card Accounts

Major Credit Card: [ ] VISA [ ] Me Issuer: Issuer: [ [Discover Card [ [Am Ex [] Other:
_

Account No.: Account No.: Name of Creditor .

Major CreditCard: [ ] VISA [ ] MC [] Discover Card [ ] Am Ex~[ ] Other:

Loans

Type of Loan
(mortgage, car, student loan, etc.)

Monthly Payment

Other Major Obligations

Type Payee Amount Owed Monthly Payment

Miscellaneous
Describe the number and type of pets you want to nave in the rental property: Describe water-filled furniture you want to have in the rentalproperty: Do you smoke? [] yes Been sued? [] yes []no Have you ever: Filed for bankruptcy?
[] yes [] no

_ _ How many times _ _ _ _ [] no How many times

[] no How many times

Sued someone else? [ ] yes

Been evicted?' [ ) yes [] no How many times Explain any "yes" listed above:

Been convicted of a crime? [ ] yes [ ] no How many times

References and Emergency Contact

Personal Reference: Admess:_~ Personal Reference: Admess: ~ Contact in Emergency: Address: Relationship: -------Relationship: ~---------------------Relationship: ~~
Phone. , _

_ Phone: Phone: _ _ _ _

Source: Where did you learn of this vacancy?

I certify that all the information given above is true and correct and understand that my lease or rental agreement may be terminated if I have made any material false or incomplete statements in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers; and personal references. I give permission for the landlord or its agent to obtain a consumer report about me for the purpose of this application, to.ensure that I continue to meet the terms of the tenancy, for the collection and recovery of an>:financial obligations relating to my tenancy, or for any other permissible purpose.

Applicant _--,.-----~-..:..---,--__,_---:..------.,_ Notes (Landlord/Manager): -..:.. __ -"--__ -'-...;,.-

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