Residential Resident Info Form

Residential Resident Info Form

Property Identification

Property Address:

Resident Information

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

Length of Residence at Current Address: years    months

Employment & Income

Employer Phone:   Position:

Emergency Contact

Phone:   Relationship:

Vehicles & Parking

Pets

Pets on Premises? Yes No

References

Background Disclosures & Authorizations

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

Have you been convicted of a felony or misdemeanor that may be relevant to residency? Yes No

Have you filed bankruptcy in the past seven (7) years? Yes No

Authorization to Obtain Consumer Reports: I authorize the landlord or agent to obtain consumer reports, credit reports, criminal background checks, and tenant screening reports for the purpose of evaluating residency eligibility. I certify that all information provided in this form is true and complete. I understand that false or misleading statements are grounds for denial or termination of residency.

Authorization to Verify Income and Employment: I authorize verification of employment, income, rental history, and references.

Lead-Based Paint and Other Disclosures

Was the structure built before 1978? Yes No

Smoke Detector / Carbon Monoxide: Tenant acknowledges that functioning smoke detectors and carbon monoxide alarms are required by law where applicable and that Tenant must report any malfunction to Landlord immediately. Acknowledged

Acknowledgements, Certifications, and Notices

Certification: I certify under penalty of perjury that the information in this form is complete and accurate to the best of my knowledge. I understand this form becomes part of my tenant file and may be used by Landlord or Agent in connection with occupancy and ongoing tenancy matters. I agree to promptly notify Landlord or Agent in writing of any material changes to the information provided herein.

For Landlord / Agent Use Only

Move-in Date:   Monthly Rent:   Security Deposit:

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