GCAAR Rental Application

RENTAL APPLICATION

(For Use in Montgomery County, Maryland and Washington, DC)

Applicant’s Name:

Application is made to lease property located at

for monthly rental of $ Security Deposit: $

Lease Term: Move-in Date: Move-out Date:

A deposit in the amount of $ (“Earnest Money Deposit”) is to be held by Listing Broker.

Additionally, a non-refundable fee of $ is to be used for the credit/consumer check and processing the application.

SPECIAL LEASE REQUIREMENTS:

Military/Diplomatic Clause: Yes No

Contingencies/Special Equipment:

OCCUPANTS

Total Number of Occupants:

Name: Age:

Name: Age:

Name: Age:

Name: Age:

Pets: Dog Breed: Weight: Cat Other

How many pets total?

AUTOMOBILES, MOTOR CYCLES, TRUCKS, BOATS, AND TRAILERS

Total Number of Vehicles:

Type/Make: Year: Tag #: State:

Type/Make: Year: Tag #: State:

Are any of the above commercial vehicles? If so, which ones?

Date Application Received by Agent/Broker:

Applicant Information

Applicant's Name:

Birth Date: SS#:

Driver's License # or Government-Issued ID #: State:

Home Phone: Temporary Local # (if applicable):

Office Phone: Mobile Phone:

Current Address

Street City State Zip

Own Rent Years: Rent/Mortgage Payments: $

Present Landlord/Agent: Phone:

Reason for moving:

Previous Address:

City State Zip

Landlord/Agent's Name: Phone:

From (Date): To: Monthly Rent: $

Previous Address:

City State Zip

Landlord/Agent's Name: Phone:

From (Date): To: Monthly Rent: $

Employment Information

Current Employer:

Position: How Long:

Address:

City State Zip

Supervisor: Supervisor’s Phone:

Previous Employer:

Position: How Long: Gross Income: $

Address:

City State Zip

Supervisor: Supervisor’s Phone:

Current Gross Annual Income

Base Pay: $ Overtime: $

Bonuses: $ Dividends: $

Commissions: $ Other: $

TOTAL: $

Assets

Checking Account: $ Bank: Acct. #:

Savings Account: $ Bank: Acct. #:

Credit Union: $ Name: Acct. #:

Other Assets: $ (Specify)

TOTAL: $

Liabilities

Creditor Total Due $ Monthly Terms $

Creditor Total Due $ Monthly Terms $

Creditor Total Due $ Monthly Terms $

Creditor Total Due $ Monthly Terms $

TOTAL: $ $

Have you ever filed for bankruptcy? Yes No Date:

Do you have suite for judgments against you? Yes No

Citizen of (Country): Passport #:

Emergency Contact: Relationship:

Address Phone:

Local References

Name: Relationship:

Address: Phone:

Name: Relationship:

Address: Phone:

The applicant hereby authorizes Listing Broker/Landlord to order and obtain a credit/consumer report. I hereby authorize the owner or owner’s agent to investigate and report references, employment, rent history, and financial responsibility.

The applicant hereby releases Listing Broker/Landlord from any liability whatever for rejection of this application due to credit information or any other reason.

This application shall become part of any lease agreement executed between the Landlord and/or Agent and the applicant, and any false or misleading statement shall be considered a substantial breach of said lease.

Maryland Properties Only

1. In the event the application is approved, but the applicant fails to sign a lease within the time provided, the Landlord/Agent shall retain a portion of the deposit as specified herein.

2. The provisions of Paragraph 1 do not apply to any Landlord/Agent who offers four or less dwelling units or to seasonal or condominium rentals.

3. I certify that I have received and carefully examined a copy of the lease and any addenda and agree to pay all applicable utilities.

4. Should I sign a lease, I understand that the security deposit may not exceed the maximum permitted by law.

I understand that this APPLICATION DOES NOT CONSTITUTE A COMMITMENT to lease or rent and that a WRITTEN LEASE WILL BE PREPARED if my application is approved.

The undersigned applicant affirms under the penalties of perjury that the information provided is true and correct to the best of my knowledge.

Check: $ Cash: $

Leasing Broker: Broker Code:

Address: Phone:

Leasing Agent: GCAAR #: Phone: