Residential Home Application

RESIDENTIAL HOME APPLICATION

Property applied for:   APN / Parcel #:

Requested Occupancy and Term

Desired move-in date:   Requested lease term (months):

Applicant Information

Date of birth:   Phone:

Length of residence:   Monthly rent/mortgage:

Employment and Income

Employer phone:   Position:   Monthly gross income:

Previous Residence

Previous landlord:   Reason for leaving:

Occupants, Vehicles, and Pets

Number of occupants:   Names of occupants (relationship / age):

Vehicles (make/model/license):

Pets? Yes No

Background and Disclosures

Have you ever been evicted? Yes No

Have you ever been convicted of a felony? Yes No

Have you filed for bankruptcy in the past 7 years? Yes No

Is the dwelling unit built prior to 1978? Applicant acknowledges potential lead-based paint hazard disclosure requirements. Yes No

References

Applicant Authorization and Certification

I certify that all information provided in this application is true and complete. I authorize the property manager and owner, and their agents, to verify the information in this application, to obtain consumer reports, credit reports, criminal background checks, eviction history, and rental payment history from consumer reporting agencies and other sources, and to contact employers, landlords, and references. I release all parties from liability for providing such information.

I understand and agree that misstatements, omissions, or false information may constitute grounds for denial of this application and, if discovered after move-in, may constitute grounds for termination of tenancy. I further understand that submission of this application does not create a tenancy or binding lease until a written lease agreement is signed by all parties.

Application fee (if any) is non-refundable and covers the cost of screening. I acknowledge receipt of the fee policy: I acknowledge

By signing below I authorize verification as described above and certify under penalty of perjury that the information contained in this application is true and accurate.

Additional Information

Governing law: This application and any lease arising from it shall be governed by the laws of the state where the property is located. This application constitutes the entire statement of applicant's representation for qualification; no oral statements alter this application.

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