RENTAL APPLICATION

THIS FORM TO BE COMPLETED IN FULL BY APPLICANT. THIS APPLICATION MUST BE ACCOMPANIED BY A SIGNED RENTAL CRITERIA STATEMENT WHICH IS ATTACHED.

1. PREMISES INFORMATION:
Address: __________________________________________________________________________________________________________ Desired Move-in Date: _______________________________ Monthly Rent:__________________________________________________

2. CONTACTINFORMATION:
First Name: _________________________________ MI: _____ Last Name: ___________________________________________________ Email: _____________________________________________________________________________________________________________ Home Phone: __________________________ Work Phone: ________________________ Cell Phone: ___________________________

3. PERSONALINFORMATION:
IDENTIFICATION: (For purpose of obtaining credit reports)

Date of Birth: ________________________ Social Security Number: _______________________________________________________ Driver’s License Number: _____________________________ Driver’s License State: _________________________________________

EMERGENCY CONTACT:

Name: _______________________________________________________________Relationship:_________________________________ Address: _____________________________________________________________Phone: ______________________________________

VEHICLE:

Make: _________________ Model: __________________Year: ______Color: _____________ License Number:_____________________ Other vehicle(s): ___________________________________________________________________________________________________

OTHER:

Name(s) of all other proposed occupant(s) and relationship to applicant: __________________________________________________ __________________________________________________________________________________________________________________

Pet(s) or service animals (number and type) ___________________________________________________________________________ Has applicant ever been a defendant in an unlawful detainer (eviction) lawsuit or defaulted (failed to perform) any obligation of a

rental agreement or lease? No Yes If yes, explain: _____________________________________________________________ Has applicant ever been convicted of felony manufacture or sale of controlled substances?  No  Yes

If yes, explain: _____________________________________________________________________________________________________

Has applicant ever filed suit against a landlord? No Yes
If yes, explain: ____________________________________________________________________________________________________

Does applicant have a water bed, aquarium or any other water-filled furniture?  No  Yes Type: ________________________ Is the applicant a smoker? No Yes If yes, explain: ______________________________________________________________

4. RESIDENCE HISTORY
Current Address: _______________________________________ City/State/Zip: __________________________________________ From: ____________________ To: _________________________ Monthly Rent: __________________________________________ Landlord/Manager: _____________________________________ Landlord/Manager’s Phone:______________________________ Reason for Leaving: ____________________________________

Previous Address: ______________________________________ City/State/Zip: __________________________________________ From: ____________________ To: _________________________ Monthly Rent: __________________________________________ Landlord/Manager: _____________________________________ Landlord/Manager’s Phone:______________________________ Reason for Leaving: ____________________________________

___________________________________________________________

___________________________________________________________

5. EMPLOYMENT AND INCOME
Employer: ______________________________________________________ Employer’s Phone: _________________________________ Address: ___________________________________________________City/State/Zip: __________________________________________ Position or title: _______________________________________ Monthly Salary: ___________________ Years Worked: ______________ Supervisor’s Name: _________________________________________________________________________________________________

Applicant represents that all the above statements are true and correct, authorizes verification of the above items and agrees to furnish additional credit references upon request. Applicant authorizes the Owner/Agent to obtain reports that may include credit reports, unlawful detainer (eviction) reports, bad check searches, social security number verification, fraud warnings, previous tenant history and employment history. Applicant consents to allow Owner/Agent to disclose tenancy information to previous or subsequent Owner/Agents.

_______________________________________________________________________________ ________________________________ Signature Date