SAMPLE RESIDENTIAL RENTAL APPLICATION

                

[list landlord's name, address, and phone]
 



RESIDENTIAL RENTAL APPLICATION 
( Each adult to complete separate application ) 


                                             Property/Unit:_________ 

Please print clearly 

1. Name of Applicant_____________________________ Phone_____________ 

Present Address_____________________________________________________ 

How Long There?____________________ S.S. Number________-____-_______ 


2. Present Landlord______________________________ Phone_____________ 

Address_____________________________________________________________ 

Monthly Rent________________________ Reason for Leaving_____________ 


3. Previous Landlord_____________________________ Phone_____________ 

Address_____________________________________________________________ 

Monthly Rent____________________________How Long There?_____________ 

Reason for Leaving__________________________________________________ 


4. Full names of all individuals (and ages of all children) who will 

be occupying premises_______________________________________________ 


5. Pets (specify)___________________________________________________ 


6. Have you ever been evicted, sued for nonpayment of rent, or 

breached a lease (if so, explain)?__________________________________ 


7. Present Employer______________________________ Phone_____________ 

Address______________________________________Occupation_____________ 

Gross Monthly Salary_______________Length of Employment_____________ 


8. Previous Employer_____________________________ Phone_____________ 

Address______________________________________Occupation_____________ 

Gross Monthly Salary_______________Length of Employment_____________ 


9. Other Income, if any (specify source)____________________________ 


10. Bank-Checking Account_____________________Account Number________ 

Address____________________________Approximate Balance______________ 


11. Bank-Savings Account______________________Account Number________ 

Address____________________________Approximate Balance______________ 


12. Bank-Additional Account___________________Account Number________ 

Address____________________________Approximate Balance______________ 


13. Credit Cards: 

(1)_________________Bank___________________Card Number______________ 

(2)_________________Bank___________________Card Number______________ 

(3)_________________Bank___________________Card Number______________ 


14. Loans: 

(1)Lender______________________________________Balance______________ 

Address________________________________Monthly Payment______________ 

(2)Lender______________________________________Balance______________ 

Address________________________________Monthly Payment______________ 


15. Other Debts and Obligations, if any (specify)___________________ 


16. Personal Reference___________________________ Phone_____________ 

Address_____________________________________________________________ 


17. Automobiles: 

Your License Number________________________________________State____ 

(1)Make/Model______________Year___________Plate____________State____ 

(2)Make/Model______________Year___________Plate____________State____ 


18. In case of emergency notify_____________________________________ 

Address__________________________________________ Phone_____________
I certify that the above information is true and complete. I authorize the verification of this information by contacting any or all individuals and financial institutions listed above. I understand that this is not a lease or an offer to rent. No binding obligation of any kind exists between the owner and myself unless and until a lease is signed. This Application is subject to prior Applications. This Application shall remain the property of the owner.
 

Signature of Applicant________________________________Date__________ 


	NO PERSON SHALL BE DENIED THE RIGHT TO RENT OUR PROPERTY 
	BECAUSE OF THEIR RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN 
	OR ANCESTRY.