Rental History
Name of current landlord: _____________________________________________________________________
Address and phone no. of current landlord: ________________________________________________________
Date current lease expires: _____________________________________________________________________
How long have you lived at your current address? __________________________________________________
Your immediately previous address:
___________________________________________________________________________________________
Name of immediately previous landlord: __________________________________________________________
Address and phone no. for immediately previous landlord: ____________________________________________
Have you ever been evicted or sued by a landlord? ____________ If yes, explain _____
___________________________________________________________________________________________
___________________________________________________________________________________________
Other
Number of occupants covered by this application: ________ adults _________ children
Name, address and phone no. of closest relative not residing with applicant: ______________________________
___________________________________________________________________________________________
Nature of the relationship to that relative: _________________________________________________________
Name of your current creditors, including charge cards, student loans and commercial loans:
___________________________________________________________________________________________
Have you ever filed for bankruptcy? _______________ If yes, when _______________
Conditions
Landlord may refuse to rent to Applicant if any of the information provided herein is found to be untrue or false.
If Landlord rents premises to Applicant, possession of the unit shall not be provided to Applicant until, in
Landlord’s sole discretion, the premises are ready for occupancy.
The following is not allowed at the rental property: Pets, Smoking, Waterbeds.
Parking is provided on-site. Tenant will be allowed to park at any non-assigned spots.
Except as provided in the lease, the Landlord shall not be liable for damages in the event the premises are not
ready for occupancy on the date prescribed in the lease, and Landlord shall not be liable for damages in any event
where the premises cannot be occupied on the prescribed date because of causes beyond Landlord’s control.
I authorize the person to whom this application is made and any credit bureau or other investigative agency
employed by such person to investigate any references herein listed or statements or other data obtained from me
or from any other source pertaining to my credit or financial responsibility. I also authorize the person to whom
this application is made (including his or her agents) to obtain a copy of my credit report to assist in evaluating
my application and, thereafter, to obtain and use in attempting to collect unpaid rent, late fees, or other charges
from me.
I CERTIFY THAT I AM 18 YEARS OF AGE OR OLDER AND THAT ALL OF THE INFORMATION I
HAVE PROVIDED IN RESPONSE TO THE QUESTIONS CONTAINED IN THIS APPLICATION IS TRUE.
I FURTHER CERTIFY THAT I HAVE READ THE CONDITIONS CONTAINED AT THE BOTTOM OF THE
APPLICATION FORM, THAT I UNDERSTAND THEM, AND THAT I VOLUNTARILY SUBMIT THIS
APPLICATION.
Dated: ___________________________ /s/____________________________
