Homeowner Rental Application

HOMEOWNER RENTAL APPLICATION

Property Identification

Property Address:

Applicant Information

Applicant Name:

Date of Birth:    Phone:    Email:

Co-Applicant / Additional Occupant

Co-Applicant Name:

Relationship to Applicant:    Date of Birth:

Occupants & Pets

Desired Lease & Financial Information

Desired Move-In Date:    Monthly Rent Proposed: $

Employment & Income

Employer Address:

Position:    Supervisor:

Monthly Gross Income: $    Length of Employment:

Rental History (Current and Previous)

Monthly Rent Paid: $    Lease Term:

Personal References & Emergency Contact

Vehicle Information

Background Questions (Answer all)

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

Have you been convicted of a felony within the past 7 years?   Yes   No

Disclosures & Attachments

Lead-Based Paint (if property built before 1978):   Yes   No

Known Mold or Water Damage:   Yes   No

Prior Material Damage to Property:   Yes   No

Photo ID   Proof of Income   Reference Letters

Authorizations, Fees & Certification

I understand that submission of this application authorizes the property owner or its agents to obtain consumer credit reports, criminal background checks, eviction history, employment and income verification, and landlord references for the purpose of evaluating suitability for tenancy. I hereby authorize any person or entity contacted to release such information. I acknowledge payment of any non-refundable application fee as permitted by law and understand that acceptance of this application is subject to screening and final approval by the property owner.

I certify under penalty of perjury under the laws of the applicable jurisdiction that the information provided in this application is true, correct and complete. I agree that false statements or omissions are grounds for denial of this application or subsequent termination of tenancy.

Applicant Certification

By signing below, Applicant acknowledges that this application is an offer to rent and does not constitute a lease or a guarantee of tenancy. The property owner reserves the right to accept or reject this application for lawful reasons. Applicant agrees to indemnify and hold harmless the property owner and its agents for actions taken in good faith in the processing of this application.

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