Personal Housing Application

PERSONAL HOUSING APPLICATION

Property Address:    Unit #:    Desired Move-in Date:

Applicant Information

Date of Birth:    Social Security Number:

Time at Current Address:    Rent or Mortgage Payment: $    Landlord Name:

Occupancy

Total Number of Occupants:

Employment and Income

Employer Address:    Employer Phone:

Position/Title:    Length of Employment:    Gross Monthly Income: $

Rental History (Previous)

Dates of Tenancy:    Landlord/Manager:    Landlord Phone:

References

Relationship:    Phone:    Years Known:

Vehicles, Pets, and Other Information

Do you have pets?    If yes, list type, breed, weight:

Criminal and Eviction History

Have you ever been convicted of a felony? Yes No

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

Emergency Contact

Relationship:    Phone:

Authorization, Certifications, and Applicant Acknowledgements

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that false statements or omissions may be grounds for denial of the application or immediate termination of tenancy. I authorize the owner/agent to verify any information provided, to obtain reports concerning my credit history, criminal background, rental history, employment and income verification, and any other records necessary to determine suitability for tenancy. I release any person or entity supplying such information from all liability for damages that may result from furnishing same.

I acknowledge that an application fee may be required and is non-refundable. I understand that submission of this application does not obligate acceptance or guarantee a lease. Approval is subject to owner/agent screening criteria and receipt of acceptable documentation.

I consent to receive communications from the owner/agent regarding this application by telephone, text message, and email at the numbers and addresses provided above. I understand that I may be required to provide proof of identity prior to lease execution.

By checking this box I authorize verification and release as described above.

I acknowledge payment or agreement to pay the non-refundable application fee in consideration of processing this application.

Fair Housing Statement

Owner/agent complies with all applicable fair housing laws. Owner/agent will not discriminate on the basis of race, color, religion, sex, familial status, national origin, disability, or any other protected characteristic.

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