Residential Rental Application
Property Address: ______________________________________
City/State/ZIP: ______________________________________
Desired Move-in Date: ________________
Monthly Rent: $__________
Security Deposit: $__________
Applicant Information
- Full Name:________________________________________
- Date of Birth:______________
- Social Security Number (optional):__________________
- Phone Number:_____________________________________
- Email Address:_____________________________________
- Driver’s License / State ID #:_______________________
- State Issued:__________ Exp. Date: __________
Co-Applicant (if applicable)
- Full Name:________________________________________
- Date of Birth:______________
- Phone Number:_____________________________________
- Email Address:_____________________________________
Rental History
Current Address: _____________________________________
City/State/ZIP: __________________________________________
- Landlord/Manager Name: _______________________________
- Phone: ____________________
- Monthly Rent: $_________
- Dates of Residency: From ______ to ______
- Reason for Leaving: ___________________________________
Previous Address: ____________________________________
City/State/ZIP: __________________________________________
- Landlord/Manager Name: _______________________________
- Phone: ____________________
- Monthly Rent: $_________
- Dates of Residency: From ______ to ______
- Reason for Leaving: ___________________________________
Employment & Income
Current Employer: ____________________________________
- Position/Title: _________________________________________
- Employer Address: ____________________________________
- Supervisor’s Name: ____________________________
- Phone: ____________________
- Monthly Income: $_________
- Length of Employment: __________
Other Income (if any): ________________________________
Source: _______________________________________________
Amount: $_________ / month
References
- Personal Reference #1:Name ________________________ Phone __________________
- Personal Reference #2:Name ________________________ Phone __________________
Other Information
- Number of Occupants:_______
- Pets (type/breed/weight):_____________________________
- Vehicles (make/model/license):________________________
- Do you smoke?☐ Yes ☐ No
- Have you ever been evicted?☐ Yes ☐ No
- Have you ever filed for bankruptcy?☐ Yes ☐ No
- Have you ever been convicted of a felony?☐ Yes ☐ No
If yes to any of the above, please explain: ____________________________________
Consent & Signature
I declare that the information I have provided is true and correct. I authorize the landlord/agent to verify all information provided, including but not limited to credit checks, background checks, rental history, and employment verification.
Applicant Signature: ________________________ Date: __________
Co-Applicant Signature: ____________________ Date: __________
Fair Housing Disclaimer
We are committed to compliance with all federal, state, and local fair housing laws. We do not discriminate against any person because of race, color, religion, sex, disability, familial status, national origin, sexual orientation, gender identity, or any other class protected by applicable laws. All applicants are considered equally and fairly.
Privacy Policy Notice
The personal information provided in this application will be used solely for the purpose of evaluating your eligibility as a tenant. This includes verification of credit history, rental history, employment, and other references. Your information will be kept confidential and will not be shared with third parties except as necessary to complete the screening process or as required by law. By signing this application, you consent to the use of your personal information.