Rental Application

Applicant Info

FULL NAME

DRIVER'S LICENSE

SOCIAL SECURITY NUMBER

BIRTHDAY

MOBILE NUMBER

EMAIL ADDRESS

Desired Residence

DESIRED RENTAL PROPERTY

DESIRED MOVE IN DATE

Current Residence

CURRENT ADDRESS

CURRENT ADDRESS MOVE IN DATE

CURRENT ADDRESS MOVE OUT DATE

CURRENT LANDLORD'S NAME

CURRENT LANDLORD'S PHONE

REASON FOR LEAVING

Previous Residence

PREVIOUS ADDRESS

PREVIOUS ADDRESS MOVE IN DATE

PREVIOUS ADDRESS MOVE OUT DATE

PREVIOUS LANDLORD'S NAME

PREVIOUS LANDLORD'S PHONE

Previous Residence

CURRENT EMPLOYER

EMPLOYMENT POSITION

EMPLOYMENT CONTACT PERSON

EMPLOYMENT CONTACT NUMBER

EMPLOYMENT ADDRESS

HOW LONG HAVE YOU BEEN EMPLOYED?

GROSS MONTHLY WAGES

OTHER INCOME

Dependents

DEPENDENT RESIDENT 1 (First Name, Last Name, DOB, Relationship)

DEPENDENT RESIDENT 2

DEPENDENT RESIDENT 3

DEPENDENT RESIDENT 4

Emergency Contact

EMERGENCY CONTACT

EMERGENCY PHONE

Personal References

REFERENCE 1 NAME

REFERENCE 1 PHONE

REFERENCE 2 NAME

REFERENCE 2 PHONE

Credit References

PRIMARY BANKING INSTITUTION

BANK ACCOUNT BALANCE

Legal Information

CIVIL RIGHTS ACT NOTIFICATION

The Civil Rights Act of 1968, as amended by the Fair Housing Amendments Act of 1988, prohibits discrimination in the rental of housing based on race, color, religion, sex, handicap, familial status, or national origin. The Federal Agency, which administers compliance with this law, is the U.S. Dept. of Housing and Urban Development.

I UNDERSTAND

IF YES, PLEASE EXPLAIN, PROVIDING THE LOCATION, NATURE AND DATE OF THE OFFENSE:

Other Information

HOW DID YOU HEAR ABOUT OUR PROPERTIES?

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