Real Estate Application Form

REAL ESTATE APPLICATION FORM

Property Identification

Property Address:

Applicant Information

Date of Birth:    Phone:    Email:

Co-Applicant / Occupants

Number of Occupants:    Ages:

Employment and Income

Employer Address:

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

Rental History

Landlord Phone:    Monthly Rent:    Dates Occupied: From To

References & Emergency Contact

Disclosures

Has the applicant ever been evicted? Yes No

Any outstanding judgments, bankruptcies, or collections? Yes No

Lead-Based Paint (for properties built before 1978): Yes No
Mold or water intrusion history at current residence? Yes No

Smoking permitted inside unit? Yes No

Pets: Yes No    If yes, describe breed, size, number:

Application Fees and Deposits

Application Fee (non-refundable): $    Holding / Reservation Deposit (if applicable): $

I acknowledge that fees paid with this application are not a rent payment and are non-refundable except as required by law. The landlord may retain fees if applicant withdraws or provides false information.

Authorization & Background Checks

Applicant authorizes verification of all information provided, including credit history, criminal background, eviction history, employment and income verification, and references. Applicant further authorizes landlords, property managers, and consumer reporting agencies to disclose information to each other for purposes of evaluating this application.

Applicant expressly consents to procurement of consumer reports and investigative consumer reports in connection with this application and any renewals or extensions. Applicant understands that adverse information may be grounds for denial.

Please indicate consent: I consent to background and credit checks.

Acknowledgements and Certifications

By signing below, Applicant certifies under penalty of perjury that the information contained in this application is true, complete, and accurate. Applicant understands that providing false or misleading information is grounds for denial or later termination of tenancy and may subject Applicant to civil or criminal penalties.

Applicant agrees that Landlord may rely on the accuracy of the statements herein, and Applicant releases all parties from liability for lawful disclosure of information in connection with this application. Applicant understands that acceptance of this application is subject to satisfactory verification and approval.

Equal Housing Opportunity: Landlord and agent comply with applicable fair housing laws. No discrimination will be made on the basis of race, color, religion, sex, national origin, familial status, disability, or other protected class.

Governing Law: This application and any subsequent rental agreement shall be governed by the laws of the state in which the property is located. This application, when approved and signed by both parties, forms the basis of the future rental agreement and contains the entire understanding between the parties with respect to the application.

Additional Information

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