RENTAL APPLICATION FORM

Name: ............................................................................................................
Phone: ..............................................
Email:
………………………………………………………………………………………………………
……………………..
DOB: ……………………………………………….
Has your driver’s license ever been suspended? …………………….
Privileges limited or revoked? Yes/ No If so, when and why? ……………………..
Current Address, including ZIP CODE:
Name, address and telephone no. of Landlord:
……………………………………………………………………………………
Length of stay: ………………………..
Rent: $...................
Owner paid all utilities: ……………………………..
Reason for leaving:
………………………………………………………………………………………………………
……………………
When would you like to take
occupancy? ............................................................................................
How much do you have at hand now for the deposit to get the keys: $..............................
Pets: Number: ……………………………….
Types: …………………………………………..
1. ………………………………………………….Weight: ………………….. Age: ………….
2. ………………………………………………….Weight: ……………………Age: …………..
Number of vehicles: …….Cars: ………….Trucks: ………………….other:
………………………………………..
Plate numbers:
………………………………………………………………………………………………………
…………..
Current employer:
………………………………………………………………………………………………………
………
Phone: ………………………… Position:
…………………………………………………………………..Length of employment:
……………………………………….
NET pay per month: $..............................
Additional income: Amount $............................ Source:
……………………………………………………….
Personal reference: (List name, address, telephone
Number and relationship)
……………………………………………………………………………………….…………….
Emergency information: (List name, address, telephone
Number and relationship)
………………………………………………………………………………………………………
…..
If you could not meet your financial obligations, who would you turn to for help?
……………………………………….
Does anyone in your household smoke? ………………………………………………………….
Have you ever been served an eviction notice or have?
……………………………………………………….
You been asked to leave a rental property? ........ If so, when? …………………………………
And why?...........................................................................................................................
Can you come up with the security deposit today to secure the house? ……………..
If the answer is yes, who will be in charge of the payment? ………………
Have your wages ever been garnished? …………… If so, when and why
Are you currently a co-signer on a loan? ………………….

I certify that all of the information listed above is truthful and complete.
Signature: …………………………………………………………
Date: ……………………………………………
Name: ………………………………………………………………………………….
Phone: ………………………………………..
Email: ………………………………………………………………………………….
DOB: ……………………………………………

Sincerely –