Rental Application

Please complete this application with all applicable details. If you are accepted as a tenant, this application will become part of the lease. If more than one tenant (other than minor children) will be occupying a unit, each must complete a separate application. By signing below, you represent that the information provided is true and complete, you authorize lessor to contact third parties to verify the information given, and you specifically authorize lessor to check on your credit through a credit-reporting agency. A non-refundable application fee of $________ must be paid to cover the lessor's expenses in verifying the information you provide. If a space provided is too small, continue your answer on a separate sheet of paper and attach it to this application.

Name:	__ Male	__ Female	Birth date:
Social Security No.:	Driver's License No.:	D/L Issuing State:
__ Single __ Married __ Separated ___________ __ Divorced ____________

How long? How long?	Current home phone:

Cell phone number:
LIST ALL PEOPLE WHO WILL RESIDE IN THE UNIT IN ADDITION TO THE APPLICANT
Names	Gender	Age	Relationship to Applicant
__ Male __ Female
__ Male __ Female
__ Male __ Female
Name & address of Applicant's Employer:

(Note: If you have other income sources, list sources, amounts and frequency of receipt on an attachment page.)	Work phone number:
Position:

Salary/Wages:	Payroll frequency:	How long employed:
Present residence address and reason for leaving:

__ Rent __ Own
How long at present residence:

If currently renting, name & phone number of landlord:
In this block list all other residence addresses for the past 5 years, along with the name, address and phone number of each landlord if you rented and the reason for leaving each residence.

State the name(s), address and telephone number of your parent(s) or guardian(s). This should be someone who would know on a permanent basis how to contact you:

Have you ever broken a lease agreement by moving before it expired? __ Yes __ No If yes, provide details:

Have you ever been evicted from any type of housing or sued for any reason by a former landlord? __ Yes __ No If Yes, provide details:

Have you ever been convicted of, pled guilty to or placed on probation for any crimes or violations of city ordinances (other than non-substance-related traffic offenses)? □ Yes □ No If Yes, list below the date, type of offense, court and city or county in which charged, disposition of case, and any comments you deem relevant.

How many vehicles would you keep at the leased premises? ______ For each vehicle, state the year, model, manufacturer, license plate number, and state of licensure. Also indicate if any vehicle has body damage, defective paint or leaking fluids.

Bank reference – Name of Bank:

Address:	Account No.:
In this block list utility companies, stores and credit card companies with which you have had credit in the past five years. Include the company name, address, telephone number and account number.

Date of Application:

Applicant's Signature:

By signing here, I specifically authorize the lessor to obtain a credit check on me through a credit reporting agency.
Date of Witness' Signature:

Signature of Witness: