1. RENTAL APPLICATION
Equal Housing Opportunity
The undersigned herby makes an application to rent the following property:
_____________________________________________________________________________________________
Anticipate move date of ____________________at a monthly rent of $ __________________________and
security deposit of $ ______________________
PLEASE TELL US ABOUT YOURSELF
Full Name ___________________________________________________________________________________
Date of Birth ___________________________________ Social Security #__________________________
Home Phone __________________________________ Other Phone __________________________________
Email Address ________________________________________________________________________(optional)
Please check preferred method of communication: email home phone other phone
What are the best times to reach you to discuss this application? ______________________________________
Names of Dependents and ages: ________________________________________________________________
Co-Applicant Name ___________________________________________________________________________
Co-Applicant Date of Birth__________________________Co-Applicant Social Security #____________________
List All Pets__________________________________________________________________________________
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address __________________________________________________Apt. #______________________
City, State, Zip_______________________________________________________________________________
Month/Year Moved In______________________________ Reason for Leaving __________________________
___________________________________________________________________
Rent $__________________

2. Owner/Agent Name ________________________________________ Phone #__________________________
Previous Address (last 3 years) _________________________________________________________________
Rent $__________________ Owner/Agent ____________________________ Phone # ___________________
Previous Address (last 3 years) _________________________________________________________________
Rent $__________________ Owner/Agent ____________________________ Phone # ___________________
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you declared bankruptcy in the past 7 years? Yes No
Have you ever been evicted from a rental residence? Yes No
Have you had two or more late rental payments in the past year? Yes No
Have you ever willfully or intentionally refused to pay rent when due? Yes No
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Employment Status: ________Full Time ________Part Time _______Student ________Unemployed
Employer ______________________________________________________________________________
Dates employed From: ________________________ To: ______________________________________
Job Title _______________________________________________________________________________
Supervisor’s Name __________________________________________ Phone ______________________
Salary $ ________________________ per ___________________________________________________
If employed by above less than 12 months, give name & phone # of previous employer or school ______
_____________________________________________________________________________________
Co-Applicants Job Status: ________Full time ________ Part Time _________Student_______Unemployed
Employer ______________________________________________________________________________
Dates employed From: ________________________ To: ______________________________________
Job Title _______________________________________________________________________________
Supervisor’s Name __________________________________________ Phone ______________________
Salary $ ________________________ per ___________________________________________________
If employed by above less than 12 months, give name & phone # of previous employer or school ______
_________________________________________________________________________________

3. If you have other sources of income that you would like us to consider, please list income, source, and
person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal
alimony, child support, or spouse’s annual income unless you want us to consider it on this application.
Amount $ ____________________Source/Contact Name ____________________________________
Amount $ ____________________Source/Contact Name ____________________________________
PLEASE LIST YOUR REFERENCES
Banking Accounts:
Name _____________________________________________________________________________________
Type of Account _________________________________ Account Number _____________________________
Name _____________________________________________________________________________________
Type of Account _________________________________ Account Number _____________________________
Personal Reference or Emergency Contact:
Name _____________________________ Address_________________________________________________
Phone _______________________ Relationship __________________________________________________
Driver’s License:
Your Driver’s License Number ____________________________________ State________________________
Co-Applicant Driver’s License Number ________________________________ State _____________________
Vehicle Information:
Make/Model ___________________________ Year ____________ License Plate State___________________
Make/Model ___________________________ Year ____________ License Plate State___________________
ADDITIONAL INFORMATION:
Please give any additional information that might help owner/management evaluate this application?
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
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