Home Rental Application Form

HOME RENTAL APPLICATION FORM

Property Information

Property Address:

Applicant Information

Date of Birth:   Phone:

Length of Residency:   Monthly Rent/Mortgage:

Previous Residence (if less than 3 years at current)

Landlord/Management Name:   Phone:

Desired Tenancy

Desired Move-in Date:   Lease Term:

Monthly Rent Applicant Can Pay:   Security Deposit Available:

Employment & Income

Employer Address:

Position/Title:   Supervisor:

Gross Monthly Income:   Other Income (source & amount):

References

Phone:   Relationship:

Phone:   Relationship:

Household, Pets & Vehicles

List all persons who will occupy the unit (name / age / relation):

Pets: Yes No   If yes, describe type, weight, and number:

Background & Screening Disclosures

Have you ever been evicted or asked to vacate a rental? Yes No

Have you ever been convicted of a felony? Yes No

Have you filed for bankruptcy in the past seven years? Yes No

Lead-Based Paint & Property Condition

Is the property known to have been built prior to 1978? Yes No

Applicant acknowledges that the landlord may require inspection or repairs related to known hazards and that the landlord's disclosures (if any) will be provided prior to lease execution.

Authorization & Certification

Applicant authorizes the landlord, property manager or their agents to verify information provided in this application, to obtain consumer reports, credit reports, criminal history, rental history and employment/income verifications. Applicant further authorizes any person or entity contacted to release such information.

Applicant certifies under penalty of perjury that all information provided in this application is true, complete and correct. False statements are grounds for denial of tenancy, forfeiture of deposits, and may constitute grounds for eviction if discovered after possession is granted.

Acknowledgment

By signing below, Applicant acknowledges that submission of this application does not constitute approval of tenancy or a binding lease. Any holding deposit required to reserve the unit is subject to a separate written agreement. Applicant understands that acceptance of false information may result in rejection of this application or immediate termination of tenancy if discovered later.

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