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I hereby apply to lease the above described premises for the term and upon the set conditions above set
forth and agree that the rental is to be payable the first day of each month in advance. As an inducement
to the owner of the property and to the agent to accept this application. I warrant that all statements
above set forth are true; however, should any statement made above be a misrepresentation or not a true
statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in
processing my application.
I hereby deposit $___________ as earnest money to be refunded to me if this application is not accepted
in 3 business banking days. Upon acceptance, this deposit shall be retained as part of the security
deposit. When so approved and accepted, I agree to execute a lease for ___________ months before
possession is given and to pay the balance of the security deposit prior to the move in date. If the
application is not approved or accepted by the owner or agent, the deposit will be refunded, the
application hereby waiving any claim for damages by reason of non-acceptance which the owner or agent
may reject. I recognize that as a part of your procedure for processing my application, an investigative
consumer report may be prepared whereby information is obtained through personal interviews with
others with whom I may be acquainted. This inquiry includes information as to my character, general
reputation, personal characteristics and mode of living.
The above information, to the best of my knowledge, is true and correct.
Please sign:
X______________________________________ _____________________________
Applicant's Signature
Date
AUTHORIZATION
Release of Information
I authorize an investigation of my credit, tenant history, banking and employment for the purposes of
renting a house, apartment, or condominium from this owner/manager.
_____________________________________________
Name (please print)
X _______________________________________ __________________________
Signature Date
APPLICANT: PLEASE DO NOT WRITE in BOX (FOR OFFICE USE ONLY)
Deposit of $_________________ Received by _________________________Date___________
OFFICE NOTES:
Please note that this doc
ument is for reference purposes. You may wish to check with your local landlord
association or obtain legal advice to make sure information is appropriate for your state. This Application was
modified and made fillable by eForms.
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