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Residential Lease Application
Property Address
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Monthly Rent
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Anticipated Move-in Date
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Security Deposit
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Referred by
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Real Estate Agent
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Fill this out if referred by Real Estate Agent
Other
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Fill this out if referred by other
Applicants Name
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Applicants former last name
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Is there a co-applicant
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If yes, co-applicant must submit a separate application.
E-mail
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Home Phone
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Work Phone
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Mobile Phone - Pager
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Social Security Num
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Drivers License Number and State
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Date of Birth
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Height
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Weight
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Eye Color
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Hair Color
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Marital Status
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Citizenship - Country
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Emergency Contact: (Do not insert the name of an occupant or co-applicant.)
Emergency Name
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Emergency Address
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Emergency Phone
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Emergency Email
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Name all other persons who will occupy the Property
Name
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Relationship
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Age
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Name 2
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Relationship 2
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Age 2
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Name 3
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Relationship 3
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Age 3
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Name 4
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Relationship 4
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Age 4
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Applicants Current Address
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Apt No
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City State Zip
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Landlords Name
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Landlords Email
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Phone(Current Address)
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Date Moved in(Current Address)
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Move Out Date(Current Address)
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Rent(Current Address)
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Reason For Move(Current Address)
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Applicants Previous Address
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Apt No(Previous Address)
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City,State Zip(Previous Address)
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Phone(Previous Address)
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Date Moved in(Previous Address)
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Move Out Date(Previous Address)
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Rent(Previous Address)
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Reason For Move(Previous Address)
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Employment Status
Applicants Current Employer
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Address
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Supervisors Name
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Phone
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Email
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Start Date
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Gross Monthly Income - current employer
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Position
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If Applicant is self employed, Landlord may require one or more previous year's tax return attested by a CPA, attorney, or other tax professional
Applicants Previous Employer
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Address
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Supervisors Name
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Phone
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Email
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Employed from
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Employed to
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Gross Monthly Income
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Position
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Describe other income applicant wants considered
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List all vehicles to be parked on the Property
Type
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Year
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Make
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Model
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License - State
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Mo Pymnt
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Type
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Year
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Make
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Model
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License - State
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Mo Pymnt
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Type
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Year
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Make
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Model
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License - State
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Mo Pymnt
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List all pets to be kept on the property (Dogs Cats Birds Reptiles Fish Other Pets)
Type and Breed
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Name
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Color
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Weight
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Age
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Gender
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Neutered
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De-Clawed
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Rabies Shots Current
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Type and Breed
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Name of Pet
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Color
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Weight
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Age of Pet
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Gender
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Neutered
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De-Clawed
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Rabies Shots Current
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Will any water-filled furniture be on the property?
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Does anyone who will occupy the Property smoke?
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Will the Applicant maintain Renters Insurance?
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Is Applicant or applicant's spouse, even if separated, in the Military
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If Yes, is the Military person serving under orders limiting the military person's stay to one year or less?
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Has applicant ever been evicted
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Has applicant been asked to move out by landlord
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Has applicant breached a lease or rental agreement
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Has applicant filed for bankruptcy
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Has applicant lost property in a foreclosure
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Has applicant had any credit problems slow pays or delinquencies
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Has applicant been convicted of a crime
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Is any occupant a registered sex offender
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Are there any criminal matters pending against any occupant
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Is there additional information applicant wants considered
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If answered yes to any of the above questions please provide explanation
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Authorization: Applicant authorizes Landlord and Landlord’s agent, at any time before, during, or after any tenancy, to: (1) obtain a copy of Applicant’s credit report; (2) obtain a criminal background check related to Applicant and any occupant; and (3) verify any rental or employment history or verify any other information related to this application with persons knowledgeable of such information. Notice of Landlord’s Right to Continue to Show the Property: Unless Landlord and Applicant enter into a separate written agreement otherwise, the Property remains on the market until a lease is signed by all parties and Landlord may continue to show the Property to other prospective tenants and accept another offer.
   
Privacy Policy: Landlord’s agent or property manager maintains a privacy policy that is available upon request.
Fees: Applicant submits a non-refundable fee for processing and reviewing this application and (check only one box if applicable):
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Please check 1 or 2 from statements below then fill in applicable
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(Option 1) To be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed.
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(Option 2) An Application Deposit of $ in accordance with the attached Agreement for Application Deposit and Hold on Property (TAR No. 2009 or similar agreement).
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Acknowledgement & Representation: (1) Signing this application indicates that Applicant has had the opportunity to review Landlord’s tenant selection criteria, which is available upon request. The tenant selection criteria may include factors such as criminal history, credit history, current income and rental history. (2) Applicant understands that providing inaccurate or incomplete information is grounds for rejection of this application and forfeiture of any application fee and may be grounds to declare Applicant in breach of any lease the Applicant may sign. (3) Applicant represents that the statements in this application are true and complete.
Applicants E-Signature and Date
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The landlord, broker, or landlord’s representative is:
Name
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Address
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City State Zip
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Phone
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Email
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I give my permission: AUTHORIZATION TO RELEASE INFORMATION (Applicant), have submitted an application to lease a property located at (address, city, state, zip). The landlord, broker, or landlord’s representative is: (name) (address) (city, state, zip) (fax) (e-mail) (phone) (1) to my current and former employers to release any information about my employment history and income history to the above-named person; (2) to my current and former landlords to release any information about my rental history to the above-named person; (3) to my current and former mortgage lenders on property that I own or have owned to release any information about my mortgage payment history to the above-named person; (4) to my bank, savings and loan, or credit union to provide a verification of funds that I have on deposit to the above-named person; and (5) to the above-named person to obtain a copy of my consumer report (credit report) from any consumer reporting agency and to obtain background information about me.
Applicants E-Signature and Date
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Submit