Rental Application

There is a non-refundable fee of $40/adult to apply
Name*
First Middle Last
Birth Date*
Social Security #*
Driver’s License #*
Any Other Names You’ve Used In The Past
Home Phone*
Cell Phone
Address of property you are applying for.
All Other Proposed Occupants
Name Birth Date Relationship To Applicant Social Security Number Prior Address

Click + to add more occupants
RENTAL/RESIDENCE HISTORY
Street Address*
Current Residence Previous Residence
City*
Current Residence Previous Residence
State & Zip*
Current Residence Previous Residence
Last Rent Amount Paid
Current Residence Previous Residence
Owner/Manager and Phone Number
Current Residence Previous Residence
Reason for leaving
Current Residence Previous Residence
Is/Was rent paid in full?
Current Residence Previous Residence
Did you give notice?
Current Residence Previous Residence
Were you asked to move?
Current Residence Previous Residence
Dates of Residency
From/To From/To
EMPLOYMENT HISTORY
Employed By*
Current Employment Previous Employment
Address*
Current Employment Previous Employment
Employer’s Phone*
Current Employment Previous Employment
Occupation
Current Employment Previous Employment
Name of Supervisor
Current Employment Previous Employment
Monthly Gross Pay*
Current Employment Previous Employment
Dates of Employment*
From/To From/To
CREDIT HISTORY
Savings Account
Bank/Institution Name Balance On Deposit or Balance Owed
Checking Account
Bank/Institution Name Balance On Deposit or Balance Owed
Credit Card
Bank/Institution Name Balance On Deposit or Balance Owed
Auto Loan
Bank/Institution Name Balance On Deposit or Balance Owed
VEHICLES
(Include vehicles belonging to other proposed occupants also)
Make Model Color Year License Plate

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REFERENCES & EMERGENCY CONTACTS
Name*
Emergency Contact Name Emergency Contact Phone number
By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you. Furthermore, if you abandon the apartment for any reason then you grant us permission to allow your relative listed above to remove all contents of the dwelling on your behalf.
GENERAL INFORMATION
Have you ever been served a late rent notice?
Do any of the people who would be living in the apartment smoke?*
How long do you think you would be renting from us?*
Have you ever filed for bankruptcy? If so, when?*
When would you be able to move in?*
Have you been convicted of a felony?
Have you ever been served an eviction notice? If so, when?
Pets
Type Breed Approx Weight Age

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Have you had any reoccurring problems with your current apartment or landlord? If yes, please explain:
Why are you moving from your current address?
List any verifiable sources and amounts of income you wish to have considered (optional):
If you were to run into financial difficulty in the future and couldn’t come up with the money to pay the rent, do you know someone that would loan you the money? If so, provide the person’s name, address, & phone # so that we can use them as a reference for you.
Have you been a party to a lawsuit in the past? If yes, please explain why:
We may run a credit check and a criminal background check. Is there anything negative we will find that you want to comment on?
How did you hear about this RENTAL?
Do you have an e-mail address we can reach you at?*
Applying Fee*
Price: $40.00
Number of additional applicant
Driver's License / State identification*
Accepted file types: jpg, png, pdf.
Total
$0.00
Payment Method
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Agreement & Authorization Signature
Terms of Service*
I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification
of information I provided and communication with any and all names listed on this application. I understand that any discrepancy or
lack of information may result in the rejection of this application. I understand that this is an application for a rental and does not
constitute a rental or lease agreement in whole or part. I further understand that there is a non-refundable fee to cover the cost of
processing my application and I am not entitled to a refund even if I don’t get the RENTAL.
- I agree to the Terms of Service
Signature*
Signature*
Date*

RENTAL APPLICATION

RENTAL/RESIDENCE HISTORY

EMPLOYMENT HISTORY

CREDIT HISTORY

VEHICLES

REFERENCES & EMERGENCY CONTACTS

GENERAL INFORMATION

Payment Method

Agreement & Authorization Signature