Residential Renters Application

Residential Renters Application

Property Identification

Property Address:

Applicant Information

Date of Birth:   Driver's License / ID #:   State:

Current Address

Landlord / Manager:   Phone:

Monthly Rent Paid:   Lease Start:   Lease End:

Previous Address (if less than 3 yrs at current)

Previous Landlord:   Phone:

Monthly Rent:   Lease Dates:

Employment & Income

Supervisor:   Phone:

Position:   Gross Monthly Income:

Additional Occupants & Pets

Pet Deposit / Fee (if applicable):   Number of Pets:

Vehicle Information

License Plate #:   State:

Require Parking?

Emergency Contact

Background & Rental History Disclosures

Have you ever been evicted? Yes   No

Have you been convicted of a felony? Yes   No

Do you smoke tobacco or vape inside the dwelling? Yes   No

Requested Tenancy & Financial Terms

Desired Lease Term (months):   Desired Move-In Date:

Proposed Monthly Rent:   Security Deposit Requested:

Authorization & Certification

By submitting this application, Applicant certifies that all information contained herein is true and complete. Applicant authorizes the owner, property manager, or designated screening agent to verify information and to obtain consumer reports, credit history, criminal background checks, rental history, employment verification and other screening information as necessary to evaluate this application. Applicant releases all providers of information and the owner/manager from liability for damages that may result from the use or disclosure of such information.

Applicant understands that false statements or omissions may be grounds for denial of this application or, if tenancy is granted, for termination of tenancy. Applicant agrees to promptly notify the owner/manager of any material changes to the information provided.

Application Fee (non-refundable):    I agree to pay the stated application fee for processing.

Applicant further authorizes current and former landlords, employers, and references to release information concerning Applicant to the owner/manager and waives any right to privacy or claims related to such disclosures.

Lead-Based Paint / Property Condition Disclosure

If the property was built prior to 1978, there may be a risk of lead-based paint. Applicant acknowledges receipt of any required disclosure or acknowledges that the applicant has been informed that a lead-based paint disclosure may be provided at the time a lease is offered.

Consent to Terms

I hereby certify under penalty of perjury that the information provided in this application is true and correct. I authorize verification and release as described above and agree that electronic or facsimile copies of this authorization shall be as valid as the original.

Sign Now