(_____) Applicant Initial (_____) Applicant initial (_____) Landlord initial 1
Applicant(s) Name(s) If applicants
are not married please complete separate application.
__________________________________________
__________________________________________
Applicant(s) apply to _______________________ (the landlord) on _______,
____(date) for
rent of the described property below in the county of ______________ for occupancy beginning
_______,
______ and ending on _______,
_____, at a monthly rate of $______.
Property address: __________________________________________________________
Applicant date of birth ___________ Social
security number______________ work number
____________ Cell phone ________________ email
_______________________
Driver’s
license State and Number ___ ____________________
Other names applicant has used in past 5 years ____________________________________
Occupant names other than the applicant and relation
____________________________________________________________________________
____________________________________________________________________________
Do you smoke?
Y or
N Have you declared bankruptcy in the past 7 years?
Y or
N
Do you have a pet(s)?
Y or
N
Have you ever been convicted on a felony?
Y or
N
Have you ever been evicted?
Y or
N
Present address: ____________________________________________________________
How Long? _______ Monthly rent: ______
Reason for leaving? ___________________________
Previous owner or property manager’s name, phone number, and email:
Name: ___________________(ph) ______________ (email)__________________________
Previous Address:
Last 5 years previous address
From ______ to _____ Monthly rent: _______ Address: _______________________________
Reason for leaving: ____________________________________________________________
Previous owner or property manager’s name, phone number, and email:
Name: ___________________(ph) ______________ (email)__________________________
From ______ to _____ Monthly rent: _______ Address: _______________________________
Reason for leaving: ____________________________________________________________
Previous owner or property manager’s name, phone number, and email:
Name: ___________________(ph) ______________ (email)__________________________
Single Family Residential Rental Application
(_____) Applicant Initial (_____) Applicant initial (_____) Landlord initial 2
From ______ to _____ Monthly rent: _______ Address: _______________________________
Reason for leaving: ____________________________________________________________
Previous owner or property manager’s name, phone number, and email:
Name: ___________________(ph) ______________ (email)__________________________
From ______ to _____ Monthly rent: _______ Address: _______________________________
Reason for leaving: ____________________________________________________________
Previous owner or property manager’s name, phone number, and email:
Name: ___________________(ph) ______________ (email)__________________________
From ______ to _____ Monthly rent: _______ Address: _______________________________
Reason for leaving: ____________________________________________________________
Previous owner or property manager’s name, phone number, and email:
Name: ___________________(ph) ______________ (email)__________________________
Employment Information:
Applicant’s current employer: _________________________ Date hired? ________
Address: ___________________________________ Telephone: _________________
Job title: _________________ Monthly Net Income: _______________
Supervisor name: _____________________
If less than one year, please provide previous employment information.
Applicant’s previous employer: _________________________ Date hired? ________
Address: ___________________________________ Telephone: _________________
Job title: _________________ Monthly Net Income: _______________
Supervisor name: _____________________
Other sources of income (Applicant need not disclose alimony, child support, or separate
maintenance income unless applicant would like to consider this income for qualifying purposes)
Other income: $ ___________ Source
Other income: $ ___________ Source
Nearest relative contact information:
Name: __________________________ Address: _________________________________
Telephone: ______________________ Relationship: ______________________________
(_____) Applicant Initial (_____) Applicant initial (_____) Landlord initial 3
Spouse Information:
Spouse date of birth ____________Social security number______________
work number ____________ Cell phone ________________ email_______________________
Driver’s license State and Number ___ ____________________
Other name(s) spouse has used in past 5 years ____________________________________
Do you smoke? Y or N Have you declared bankruptcy in the past 7 years? Y or N
Have you ever been convicted on a felony? Y or N Have you ever been evicted? Y or N
Spouse employment:
Spouse current employer: _________________________ Date hired? ________
Address: ___________________________________ Telephone: _________________
Job title: _________________ Monthly Net Income: _______________
Supervisor name: _____________________
If less than one year, please provide previous employment information.
Spouse’s previous employer: _________________________ Date hired? ________
Address: ___________________________________ Telephone: _________________
Job title: _________________ Monthly Net Income: _______________
Supervisor name: _____________________
Other sources of income (Applicant need not disclose alimony, child support, or separate
maintenance income unless applicant would like to consider this income for qualifying purposes)
Other income: $ ___________ Source
Other income: $ ___________ Source
Nearest relative contact information:
Name: __________________________ Address: _________________________________
Telephone: ______________________ Relationship: ______________________________
Applicant(s) authorizes the landlord to verify employment, rental history, references, and credit
and authorizes the release of the information contained in this application.
If Landlord accepts application, Applicant agrees to execute a rental agreement for said
property and submit a deposit of $____________.
Applicant has paid $_____ nonrefundable application fee.
__________________________ _____________________________
Applicant Signature Date Applicant Signature Date
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