HAWAII RENTAL APPLICATION
Desired rent amount per month
Total Number of Occupants
County Housing? _________Yes ____________No
If County Housing applicable then please turn in your Voucher & Work Sheet.
APPLICANT: CO APPLICANT:
Name Name
Phone(hm) Phone(hm)
Employer Employer
Position_ Position_
How Long? How Long?
Supervisor Supervisor
Phone Number Phone Number
Monthly Salary Monthly Salary
Additional Monthly Income Additional Monthly Income
Source Source
Names of all other persons to occupy unit: (
attach additional sheet if needed)
Name Name
Name Name
Name Name_________________________________________
REFERENCE INFORMATION:
Current Address Past Address
City, State, Zip City, State, Zip
From To From To
Landlord Name: Landlord Name:
Landlord Phone: Landlord Phone:
Rent Amount Paid Rent Amount Paid
Reason for move_ Reason for move_
Past Address Past Address
City, State, Zip City, State, Zip
From To From To
Landlord Name:_________________________________ Landlord Name:_________________________________
Landlord Phone:_______________________ ________ Landlord Phone:________________________________
Rent Amount Paid Rent Amount Paid
Reason for move_ Reason for move_
Non Related PERSONAL REFERENCES (MUST LIST TWO):
Name: Name:
Phone: Phone: