Residential Dwelling Application

RESIDENTIAL DWELLING APPLICATION

Purpose: This application is submitted for consideration to lease the residential property identified below. Applicant certifies that all information provided is true and complete. Applicant authorizes verification of all statements, credit, criminal background, eviction records, rental history, employment, and income. Application fee, if any, is non-refundable as described below.

PROPERTY APPLIED FOR

Property Address:

Unit/Apt:   Desired Move-in Date:   Lease Term Requested (months):

APPLICANT INFORMATION

RESIDENCE HISTORY

Current Landlord/Manager:

EMPLOYMENT & INCOME

HOUSEHOLD, PETS & VEHICLES

Pets: Yes    No

BACKGROUND & RENTAL HISTORY QUESTIONS

Have you ever been convicted of a felony or misdemeanor? Yes    No

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

Do you smoke tobacco or use vaping products inside a dwelling? Yes    No

FEES, DEPOSIT & PAYMENT

Application Fee Acknowledgement: Applicant understands and agrees that a non-refundable application/processing fee may be charged for tenant screening and background checks.

DISCLOSURES

Lead-Based Paint: If the dwelling was built before 1978, federal law requires a disclosure. Was the property built before 1978? Yes    No

Mold or Water Damage Disclosure: Has the property sustained prior mold or water damage? Yes    No

Prior Structural or Fire Damage: Has the property previously experienced structural or fire damage? Yes    No

AUTHORIZATION, CONSENT & CERTIFICATION

By signing below, Applicant certifies under penalty of perjury that the information provided in this application is true and complete. Applicant authorizes the landlord, property manager, and their agents to obtain consumer reports, credit reports, criminal background checks, eviction history, employment and income verification, and rental history from third-party reporting agencies and references. Applicant releases all parties providing such information from liability for damages in providing the requested information. Applicant acknowledges that application fees are non-refundable unless otherwise required by law.

Applicant further agrees that false, misleading, or omitted information is grounds for denial of the application or for immediate termination of any lease entered into based on this application. Applicant agrees to hold landlord and manager harmless for actions taken in good faith reliance on the information and authorizations herein.

ACKNOWLEDGMENT

I acknowledge receipt of this application and the statements contained herein and certify that I have been provided with a copy of any screening fee receipt upon payment. I understand that acceptance of this application is not a guarantee of tenancy and that final approval is contingent upon satisfactory screening results and execution of a lease agreement.

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