Real Estate Home Application Form

Real Estate Home Application Form

Property Address:    Unit/Apartment #:    Parcel / APN #:

Applicant Information

Date of Birth:    Social Security Number (last 4):    Phone:

Length of Residence (years/months):    Current Monthly Rent/Mortgage:    Landlord/Manager Name:

Co-Applicant (if any)

Phone:    Email:

Employment and Income

Employer Phone:    Supervisor Name:

Position/Title:    Start Date:    Gross Monthly Income:

Rental History (Last 5 Years)

Dates Occupied: From To    Monthly Rent:

Occupants, Pets and Vehicles

Pets? Yes No    If yes, breed/weight/deposit:

Background Screening & Authorizations

Application Fee (non-refundable):    Holding Deposit (applied to first month if accepted):

I authorize verification of all information on this application, including credit reports, criminal records, eviction history, employment and rental history. I acknowledge that the application fee is earned and non-refundable for screening services and that acceptance of this application is contingent upon satisfactory screening and approval by the property owner or manager.

Criminal / Eviction History

Have you ever been convicted of a felony? Yes No

Have you ever been evicted or had a rental agreement terminated for cause? Yes No

Disclosures

Lead-Based Paint Known? Yes No

Known Mold or Water Intrusion? Yes No

Prior Structural or Fire Damage? Yes No

References / Emergency Contact

Reference Phone:    Relationship:

Emergency Contact Phone:    Relationship:

Certifications and Acknowledgements

Applicant certifies that all information provided is true and complete. Applicant acknowledges that false statements may constitute grounds for rejection of this application or termination of tenancy. Applicant understands that acceptance of this application creates no tenancy or rental rights until landlord executes a lease or rental agreement.

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