Residential Lease Application concerning
Page 2 of 4
Landlord or Property Manager’s Name: Email:
Phone:Day:__________________Nt:_________________Mb:__________________Fax:________________
Date Moved-In Move-Out Date Rent $
Reason for move:
Applicant’s Current Employer:
Address: (street, city, state, zip)
Supervisor’s Name: Phone: Fax:
E-mail:
Start Date: Gross Monthly Income: $ Position:
Note: If Applicant is self-employed, Landlord may require one or more previous year’s tax return attested
by a CPA, attorney, or other tax professional.
Applicant’s Previous Employer:
Address: (street, city, state, zip)
Supervisor’s Name: Phone: Fax:
E-mail:
Employed from to Gross Monthly Income: $ Position:
Describe other income Applicant wants considered:
List all vehicles to be parked on the Property:
Type Year Make Model License Plate No./State Mo.Pymnt.
Will any pets (dogs, cats, birds, reptiles, fish, and other pets) be kept on the Property? yes no
If yes, list all pets to be kept on the Property:
Rabies
Type & Breed Name Color Weight Age in Yrs. Gender Neutered? Declawed? Shots Current? Bite History?
Y N Y N Y N Y N
Y N Y N Y N Y N
Y N Y N Y N Y N
Y N Y N Y N Y N
Yes No
Will any waterbeds or water-filled furniture be on the Property?
Does any
one who will occupy the Property smoke?
Will Applicant maintain renter’s insurance?
Is Applicant or Applicant’s spouse, even if separated, in military?
If yes, is the military person serving under orders limiting the military person’s stay to
one year or less?
Has Applicant ever:
been evicted?
been asked to move out by a landlord?
breached a lease or rental agreement?
filed for bankruptcy?
lost property in a foreclosure?
had any credit problems, including any outstanding debt (e.g., student loans or medical
bills), slow-pays or delinquencies?
been convicted of a crime? If yes, provide the location, year, and type of conviction
below: _______________________________________________________________