Financial Residential Application

Financial Residential Application

Property and Application

Property Address:   Unit:

Application Date:   Desired Lease Term:   Target Move-in Date:

Applicant Information

Date of Birth:   Last 4 of SSN:   Phone:

Landlord / Mortgagee:   Phone:   Monthly Payment:

Employment and Income

Position:   Supervisor:   Phone:

Employment Start Date:   Gross Monthly Income:

Assets and Liabilities

Rental and Background History

Have you ever been evicted or asked to vacate by a landlord? Yes

Have you ever filed for bankruptcy, or are there outstanding judgments against you? Yes

Have you ever been convicted of a felony or crime that would affect tenancy safety? Yes

References

Application Fee, Deposit, and Payment

Application Fee:   Security Deposit (if required):   Accepted Payment Methods:

I understand that the application fee is nonrefundable and covers the cost of obtaining consumer reports and verifying information. I further acknowledge that any deposit tendered may be applied to rent or held as security upon acceptance.

Authorization, Consent, and Certification

Certification: By signing below, Applicant certifies under penalty of perjury that all information provided in this application is true, complete and correct. Applicant acknowledges that false statements may constitute grounds for denial of the application, termination of tenancy, and may subject Applicant to civil or criminal liability.

Authorization to Verify: Applicant authorizes the landlord, property manager and their authorized agents to verify any information provided, to obtain consumer credit reports, tenant screening reports, criminal background checks, employment verifications, rental history, and to contact credit grantors, employers, landlords, references and financial institutions as needed to evaluate this application. This authorization includes obtaining information through electronic databases and verbal or written inquiries.

Release and Hold Harmless: Applicant releases from liability any person or entity that provides requested information and holds landlord and its agents harmless for acts performed in good faith to verify the application. Applicant agrees that photocopies or electronic reproductions of this application and signature(s) shall have the same force and effect as the original.

Data Use and Retention: Applicant understands that personal information provided will be used solely for screening, lease administration, and related business purposes and will be retained as necessary in accordance with standard business practices and legal requirements.

Consent to Electronic Signature and Notice: Applicant consents to electronic communication and electronic signatures for purposes related to this application and any resulting tenancy. Applicant may request a paper copy of any document provided electronically.

I authorize verification as described above: I consent

Acknowledgment

Applicant acknowledges that acceptance of this application is at the sole discretion of the landlord. Submission of this application does not constitute a promise to rent. Any lease offer will be conditioned upon satisfactory verification of information and receipt of required funds. Applicant agrees to promptly notify landlord in writing of any change to the information provided prior to occupancy.

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