Rental Apartment Application

RENTAL APARTMENT APPLICATION

Applicant Information

Date of Birth:    Social Security Number:

Current Address

Landlord/Owner:    Phone:

Monthly Rent: $    Move-in Date:    Move-out Date:

Previous Address (if less than 3 years at current)

Previous Landlord:    Phone:

Previous Rent: $    Dates Occupied:

Employment and Income

Position:    Supervisor:

Employer Phone:    Gross Monthly Income: $    Start Date:

Co-Applicant / Other Occupants

Relationship to Applicant:    Phone:

Vehicle(s)

Pets

I will have pets on the premises

Background and Rental History Disclosures

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

Have you been convicted of a felony or misdemeanor (excluding minor traffic offenses)?   Yes   No

Emergency Contact

Authorization and Consent

I authorize the landlord, its agents and employees to verify all information provided on this application, including but not limited to rental history, employment, income, credit, criminal and eviction records. I understand such verification may include obtaining consumer reports and public records. I authorize any person or entity with relevant information to provide it to the landlord.

I consent to credit and background checks as described above.

Application Fee: $    Receipt Issued:

Holding Deposit (if any): $    Refundable: Yes   No

By submitting this application I certify that the information provided is true and complete. I understand that false or omitted information is grounds for denial of the application or termination of tenancy. I release all parties from liability for furnishing such information.

Office Use Only

Application Received By:    Date Received:

Decision:    Date:

Applicant Certification and Signature

I hereby certify under penalty of perjury that the information provided in this application is true and correct. I understand that this application is not a lease and does not obligate the landlord to rent to me. I acknowledge the landlord may rely on this information in making a rental decision.

Sign Now