Renter Information

Property Interested In:
Name:
Date of Birth: Home phone
Cell: Name and ages of children

Personal History

Present Address: City/State/Zip
Landlord Name: Phone:
Monthly Rent: Dates: From
To

Previous Address: City/State/Zip
Landlord Name: Phone:
Monthly Rent: Dates: From
To

Employment History

Present Employer: Position:
Address: City/State/Zip
Supervisor's Name: Phone:
Gross Salary: Dates: From
To

Previous Employer: Position:
Address: City/State/Zip
Supervisor's Name: Phone:
Gross Salary: Dates: From
To

Reference

Please list personal references: (Not Relatives)

Name: Phone:
Address: City/State/Zip
Years Acquainted:

Name: Phone:
Address: City/State/Zip
Years Acquainted:

Nearest Relative

Name: Phone:
Address: City/State/Zip
Relationship:

By completing and signing this application the applicant has agreed to the following terms. The applicant information is protected and will only be used by the landlord for purposes of this housing application. The information provided may be used to 1) perform a credit check on the application, 2) an eviction check to show tenant history of potential eviction filings or judgments at any point in the last 7 years, 3) perform a criminal history check to show any records involving the tenant in state court criminal records or in databases such as the national sex offender registry, 4) to contact past personal and rental references for information pertaining to the applicant only in regards to past rental history and financial and legal reliability. If any adverse action is found while conducting these checks, an adverse action notice will be sent to the applicant which will include 1) the agency's name, address and phone number that supplied the report, 2) a statement explaining that the agent did not make the decision for the adverse action themselves and as a result they can't explain why the decision was made, and 3) a statement explaining the applicant's right to dispute such information and their right to a copy of the report in question within 60 days.

Type your initials: Monday November 29th 2021
Please check all information before submitting.