Residential Application for Lease

RESIDENTIAL APPLICATION FOR LEASE

Property Information

Property Address:

Unit/Apartment #:   Parcel/APN #:

Requested Lease Terms

Start Date:   End Date:

Proposed Move-In Date:   Number of Occupants:

Applicant Information

Date of Birth:   Social Security #:

Current Residence

Landlord/Manager:   Phone:

Monthly Rent/Mortgage:   Occupied From:   To:

Previous Residence (If less than 3 years at current)

Previous Landlord:   Phone:

Employment and Income

Supervisor:   Phone:

Position:   Length of Employment:

Additional Occupants, Vehicles & Pets

Do you have pets? Yes No

References and Emergency Contact

Background and Disclosures

Have you ever been evicted, had a tenancy terminated, or been asked to vacate? Yes No

Have you ever been convicted of a criminal offense (excluding minor traffic violations)? Yes No

Are you required to register as a sex offender? Yes No

Is the dwelling built before 1978 (lead-based paint disclosure)? Yes No

Applicant Certification and Authorization

I certify that all statements in this application are true and complete. I understand that false or misleading information is cause for denial of this application or termination of tenancy. I authorize the landlord, property manager, and their agents to verify all information provided, to obtain credit reports, consumer and investigative consumer reports, criminal background checks, eviction history, and employment and rental history from third parties. I authorize any persons or entities named in this application to release information to the landlord or its agents. I agree that a photocopy or electronic facsimile of this authorization is as valid as the original.

I understand that the application fee, if any, is non-refundable to cover costs of processing, credit checks, and background checks, and that payment of a fee does not guarantee approval. I further acknowledge that approval is subject to verification of all information and compliance with screening criteria.

Applicant further acknowledges landlord may require proof of renter's insurance prior to occupancy, and that occupancy is conditioned on execution of a separate lease agreement containing the final terms and conditions of tenancy.

By checking the box below I acknowledge and consent to the terms above and the authorization to obtain consumer reports. I consent

Privacy Notice

Personal information collected in this application will be used solely for tenant screening and eligibility determination and will be handled in accordance with applicable privacy laws. Sensitive identifiers submitted for screening purposes will be protected and used only as necessary to verify identity and report consumer screening results.

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