VACATION HOME RENTAL FORM

THE PROPERTY

Property Address: ___________________________

No. of Bedrooms: ____________________ Square Feet: _____________
Rent: ____________________

Pets? ❑ Yes ❑ No Parking? ❑ Yes ❑ No Smoking Allowed? ❑ Yes ❑ No

APPLICANT INFORMATION

Applicant’s Full Name 1: __________________ Phone: _____________

Current Address: ______________________ Email: ______________
___________, ____________, ___________
Driver’s License No.: _____________________ State: _________
Date of Issuance: ______________________ Expiry Date: ____________
Social Security Number: ________________
Reason for leaving: ________________
❑ Rent ❑ Owned Monthy rent: _______________ Duration: _____________

Previous Address: ____________, ____________, ____________, ____________

Reason for leaving: _____________
❑ Rent ❑ Owned Monthy rent: ____________ Duration: ______________

Pets?: ❑ Yes ❑ No
If yes, ​Describe: ______________

Vehicle?: ❑ Yes ❑ No
If yes, ​Describe: ______________

Ever been evicted? ❑ Yes ❑ No

If yes, ​Describe: _________________

Ever been convicted of a crime? ❑ Yes ❑ No

If yes, ​Describe: _________________
Ever filed for bankruptcy? ❑ Yes ❑ No
If yes, ​Describe: ________________

Name of other occupants who will occupy the Property: ​(if applicable)

Name: ________________ Relationship: ___________ Age: _____

Name: ________________ Relationship: ___________ Age: _____
Name: ________________ Relationship: ___________ Age: _____

EMPLOYMENT INFORMATION

Current employer: _______________ Title: ___________

Employer’s address: _________________ Duration: ____________
____________, ____________, ___________
Phone: _________________ Email: _______________
Gross Income: ______________

Previous employer: _______________ Title: __________

Employer’s previous address: ___________________ Duration: ____________
____________, ____________, __________
Phone: ______________ Email: ______________
Gross Income: ____________________

REFERENCES

Full name: ______________________ Relationship: _______________

Phone: _________________________ Email: ____________________

Full name: ______________________ Relationship: _______________

Phone: _________________________ Email: ____________________

FINANCIAL INFORMATION

Bank Name 1: ______________ Branch: _____________

Contact Number: ______________
Checking Account No.: _____________ Savings Account No.: ____________
Bank Name 2: ____________ Branch: ____________
Contact Number: ______________
Checking Account No.: _____________ Savings Account No.: ____________

1st Credit Reference: _______________

Address: ____________________ Contact Number: _____________

2nd Credit Reference: ________________

Address: ____________________ Contact Number: _____________

CONSENT AND ACKNOWLEDGMENT

I/We, __________________, hereby certify that we are at least 18 years of age and the
abovementioned information is true and correct. I/We hereby authorize the Landlord,
___________________, or/his/her/their agent to conduct a background check and review
my/our credit and criminal history to prove the accuracy of the information disclosed herein.
I/We further authorize banks, creditors, credit card companies, references, and all other
persons or entities to provide the Landlord any and all information pertaining to my/our credit.
I/We understand that incorrect or incomplete information will be grounds for delay or denial of
tenancy.

______________ ____________
TENANT’S NAME DATE

______________ ____________
TENANT’S NAME DATE