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(If requested ONLINE please indicate the File(s) #: ____________ - _____________ -_____________)
RENTAL APPLICATION
Important: All information must be completed in its entirety. Please print clearly and legibly to ensure accurate
and timely processing.
Unit Applying For: _______________________________ Landlord or Property Manager Name: ______________________
Applicant #1: _________________________ _________________________ _________________________
Last Name First Name Middle Name
Any other name(s) used: _________________________ E-mail Address: ________________________________
Work Phone Number: ___________ Home Phone Number: ___________ Cell Phone Number: _________________
SS#: _______ - _______ - _______ Date of Birth: ________ - ________ - ________ DL#: ____________________
Applicant #2: _________________________ _________________________ _________________________
Last Name First Name Middle Name
Any other name(s) used: _________________________ E-mail Address: ________________________________
Work Phone Number: ___________ Home Phone Number: ___________ Cell Phone Number: _________________
SS#: _______ - _______ - _______ Date of Birth: ________ - ________ - ________ DL#: ____________________
__________________________________________________________________________________________________
Current Address: _____________________________ City: ________________________ State: ____ Zip: _________
Landlord’s Name: ________________________________ Landlord’s Phone Number: (____) ____ - ____ $: ______
Own Rent Move in date: ___ - ___ - ___ Notice given: ___ - ___ - ___ Reason for Leaving: ______________
_____________________________________________________________________________
Previous Address: _____________________________ City: ________________________ State: ____ Zip: _________
Landlord’s Name: ________________________________ Landlord’s Phone Number: (____) ____ - ____ $: ______
Own Rent Move in date: ___ - ___ - ___ Move out date: ___ - ___ - ___ Reason for Leaving: ____________
_____________________________________________________________________________
Applicant #1 Employer: ________________________________________ Email: _____________________________
Address: __________________________________ City: ___________________ State: __________ Zip: __________
Human Resources: Phone Number: (_____) ______ - ______ Fax Number: (_____) _____- ______
Position: _____________________________ Hire date: _____/ _____ / _____ Salary: $ ___________ Hr. / Mo. / Yr.
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__________________________________________________________________________________________________
Applicant #2 Employer: _________________________________________ Email: ____________________________
Address: __________________________________ City: ___________________ State: __________ Zip: __________
Human Resources: Phone Number: (_____) ______ - ______ Fax Number: (_____) _____- ______
Position: _____________________________ Hire date: _____/ _____ / _____ Salary: $ ___________ Hr. / Mo. / Yr.
__________________________________________________________________________________________________
GENERAL INFORMATION
Automobile 1: _______________________________________________________________________
Year Make/Model License #
Automobile 2: _______________________________________________________________________
Year Make/Model License #
Checking Account: _______________________________________________________________________
Bank Name Account #
Savings Account: _______________________________________________________________________
Bank Name Account #
Personal References:
1. _________________________________________________________________________________________
2. _________________________________________________________________________________________
3. _________________________________________________________________________________________
Additional Occupants Information: ________________________________________________________________
Have you ever been a party to an eviction? Yes No
Have you ever filed Bankruptcy? Yes No
Do you have any Credit Cards? Yes No Total Balance Due: $_______________________________
Do you have any Loans? Yes No Total Balance Due: $ ___________________________________
Do you have any pets? (Please indicate type and size) ____________________________________________________
Will you have a water bed? Yes No
PLEASE PROVIDE THE BEST PHONE NUMBER TO REACH YOU: (____) _____- _____
_________________________________________________________________________________________
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AUTHORIZATION
In connection with my rental application, I authorize (the “Landlord or Property
Management Company”) to obtain a “consumer report” (a background report) about me. The background
check company who will be conducting such checks is Tenant Screening Center, Inc., 6570 Oakmont Drive,
Suite B, Santa Rosa, CA 95409, toll-free phone: 1-800-523-2381, www.tsci.com.
I acknowledge the background report may contain information concerning my character, general reputation,
personal characteristics, mode of living, and credit history/standing. The types of information that may be
obtained include, but are not limited to: social security number verification, criminal records check, verification
of previous and current landlords, verification of employment, and credit reports.
Selection criteria that may result in denial of my rental application includes: criminal history; previous rental
history; credit history; or failure to provide accurate or complete information on the application form.
I agree the Landlord or Property Management Company may rely on this form to obtain background reports
throughout my tenancy without asking me for my authorization again as allowed by law. I also agree that a
copy of this form is valid like the signed original. I certify that all of the personal information I provided is true
and correct.
Signing this acknowledgment indicates that you have had the opportunity to review the landlord's tenant
selection criteria. The tenant selection criteria may include factors such as criminal history, credit
history, current income, and rental history. If you do not meet the selection criteria, or if you provide
inaccurate or incomplete information, your application may be rejected and your application fee will not
be refunded.
Washington State applicants: You also have the right to request from the consumer reporting agency a written
summary of your rights and remedies under the Washington Fair Credit Reporting Act.
_______________________________________
Print Name
_______________________________________ _____/_______/________
Applicant Signature Date (Month/Day/Year)
_______________________________________
Print Name
_______________________________________ _____/_______/________
Applicant Signature Date (Month/Day/Year)
REV09/18
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