Residential Rental Application

PROPERTY:_____________________________________________

Please complete the entire application and submit with a copy of your driver’s license, copy of your Social Security Card, last 2 weeks of payroll check stubs, and Application Fee to [LANDLORD NAME] at:

				[LANDLORD NAME]
				[LANDLORD ADDRESS]
				[LANDLORD CITY, STATE, ZIP]
				Email:       [LANDLORD EMAIL]
				Phone:	[LANDLORD PHONE]

Name___________________________________________________________________
Current Address__________________________________________________________
City_______________________________________State__________Zip____________
Telephone (Home)______________________ (Work/Cell)________________________
E-Mail__________________________________________________________________
Social Security Number____________________________________________________
Driver’s License Number_____________________________ State__________________

Occupants (List each prospective occupant, including children)
Name_________________________________ Relationship______________Age______
Name_________________________________ Relationship______________Age______
Name_________________________________ Relationship______________Age______
Name_________________________________ Relationship______________Age______
Name_________________________________ Relationship______________Age______

Pets?
If Yes, What Kind, and How Many?___________________________________________

Current Landlord_______________________ Telephone__________________________
How Long? ____________________________Monthly Rent______________________
Reason for Leaving________________________________________________________

Previous Landlord_______________________Telephone_________________________
Previous Address_________________________________________________________
City_______________________________ State___________ Zip__________________
How Long? ____________________________Monthly Rent______________________
Reason for Leaving________________________________________________________

Employer________________________________________________________________
Address_________________________________________________________________
City_______________________________ State___________ Zip__________________
Telephone_______________________________________________________________
Your Position___________________________________________How Long_________
Gross Salary/Income_____________________ per week   two weeks   month (circle one)
Take home pay_________________________ per week   two weeks   month (circle one)

Previous Employer (if less than 3 years)_______________________________________
Address_________________________________________________________________
City_______________________________ State___________ Zip__________________
Telephone_______________________________________________________________
Your Position___________________________________________How Long_________
Gross Salary/Income_____________________ per week   two weeks   month (circle one)
Take home pay_________________________ per week   two weeks   month (circle one)

Additional Employment Information
Employer________________________________________________________________
Address_________________________________________________________________
City_______________________________ State___________ Zip__________________
Telephone_______________________________________________________________
Your Position___________________________________________How Long_________
Gross Salary/Income_____________________ per week   two weeks   month (circle one)
Take home pay_________________________ per week   two weeks   month (circle one)

Emergency Contact Information (Please provide two emergency contacts).

Name______________________________________Relationship___________________
Address_________________________________________________________________
City_______________________________________State_________Zip_____________
Telephone_______________________________________________________________

Name______________________________________Relationship___________________
Address_________________________________________________________________
City_______________________________________State_________Zip_____________
Telephone_______________________________________________________________

Bank Name______________________________________________________________
Checking Account Number______________Savings Account Number_______________
Other Income not listed______________________ Source_________________________

Vehicles to be parked on property
Make_________ Model__________Color_________ Year_________License_________
Make_________ Model__________Color_________ Year_________License_________

Have you ever been evicted?________ (If yes, please explain)______________________
________________________________________________________________________________________________________________________________________________

Have you ever broken a lease?________ (If yes, please explain)____________________
________________________________________________________________________________________________________________________________________________

Have you ever been convicted of a felony? (If yes, please explain)___________________
________________________________________________________________________________________________________________________________________________

Applicant represents that the above information is true and complete, authorizes Landlord to contact current and former Landlords and Employers, authorizes credit reports to be pulled and criminal background checks to be run, and authorizes all other kinds of verification allowed by law.

__________________________________________________	__________________
Signature								Date

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