Residential Tenant Application

RESIDENTIAL TENANT APPLICATION

Please complete all sections fully. False, misleading, or omitted information is grounds for denial of this application and may be considered a material misrepresentation. The applicant authorizes verification of all information provided and consents to consumer and background screening as described below. Application fees are nonrefundable unless required otherwise by law.

Property Information

Applicant Information

Date of Birth:

Current Landlord/Owner:   Phone:

Monthly Rent: $   Lease/Month-to-Month:

Employment and Income

Position:   Supervisor:

Employer Phone:   Monthly Net Income: $

Co-Applicant / Occupants

Co-Applicant Date of Birth:   SSN:

Rental History (Previous Residence)

Previous Landlord:   Phone:

Monthly Rent: $   Dates Occupied: From To

References

Phone:   Relationship:

Phone:   Relationship:

Vehicle & Pet Information

License Plate #:   State:

Number of Pets:   Weight (if applicable):

Disclosures

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

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

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

Have you caused damage to a rental property beyond normal wear and tear? Yes   No

Lead-Based Paint Disclosure

Is the dwelling known or represented to have been built before 1978? Yes   No

Authorization & Screening Consent

I certify that the information provided in this application is true and correct. I authorize the landlord, property manager, and their agents to verify the information provided, to obtain consumer reports (credit report, criminal history, eviction history, and other tenant screening reports), and to contact references, employers, and current/previous landlords. I authorize any person or entity contacted to provide such information and release them from liability for doing so.

I understand that information obtained may be used as a basis for acceptance or denial of my application. I understand that applicants may be required to pay an application screening fee and that payment of the fee does not guarantee approval.

Applicant consents to screening:

Fee Paid:   Method of Payment:

Acknowledgment and Certification

By signing below, I certify under penalty of perjury that the foregoing information is true and complete. I acknowledge that the landlord may rely upon this application and that any material misstatement may constitute cause for denial or later termination of tenancy. I agree to notify the landlord promptly of any material change in the information provided.

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