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, ",J Rental Application SEPARATEAPPLICATIONREQUIREDFROMEACHAPPLICANTAGE18OROLDER Date and time received by landlord _ Credit Check Fee Received __ -,------- This section to be completed by landlord Address of Property to Be Rented: _ Rental Term: [ ] month to month [ ] lease from to _ Amounts Due Prior to Occupancy: First month's rent$ _ Security deposit $, _ Credit-check fee $,__ ----,, _ ~ Other (specify): $, _ TOTAL: $ _ Applicant Full Name-include all names you use(d): _ Home Phone: Work Phone: Cell Phone: _ Email: FAX: _ (by providing this fax number I agree to receive facsimile advertisements from the landlord or management company.) Social Security Number: Driver's License Number/State: _ Other Identifying Information: ----, __ --' _ Vehicle Make: Model: Color: Year: ------ License Plate Number/State: _ Additional Occupants: List everyone, including children, who will live with you. Full Name Relationship to Applicant Rental History: First-time renters: attach a description of your housing situation for the past five years. Current Address: Dates Lived at Address: _ Reason for Leaving: LandlordIManager: --'- _ Landlord/Manager's Phone: Rent: $ Security Deposit: $ _ Previous Address: Dates Lived at Address: ------------ Reason for Leaving: LandlordIManager: _ LandlordIManager's Phone: Rent: $ Security Deposit: $ _ Previous Address: Dates Lived at Address: ------------ Reason for Leaving: LandlordIManager: _ LandlordIManager's Phone: Rent: $ Security Deposit: $ _ Employment History: Self-employed applicants: attach tax returns for the past two years. Name and Address of Current Employer: '--- _ Phone: Name of Supervisor: Supervisor'sPhone: _ Dates Employed at This Job: Position or Title: ~ _ Name and Address of Previous Employer: _ Phone: Name of Supervisor: Supervisor's Phone: _ Dates Employed at This Job: Position or Title: _ Attach pay stubs for the past two years, from this employer or prior employers, LF213P Rental Application 10·08 ©nolo 1ZIBIEI_.nolo.com

Rental Application

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Page 1: Rental Application

, ",J

Rental Application SEPARATEAPPLICATIONREQUIREDFROMEACHAPPLICANTAGE18OROLDER

Date and timereceived by landlord _

CreditCheck Fee Received __ -,-------

This section to be completed by landlordAddress of Property to Be Rented: _Rental Term: [ ] month to month [ ] lease from to _Amounts Due Prior to Occupancy: First month's rent$ _

Security deposit $, _

Credit-check fee $,__ ----,, _~Other (specify): $, _

TOTAL: $ _

ApplicantFull Name-include all names you use(d): _Home Phone: Work Phone: Cell Phone: _Email: FAX: _(by providing this fax number I agree to receive facsimile advertisements from the landlord or management company.)

Social Security Number: Driver's License Number/State: _Other Identifying Information: ----,__ --' _VehicleMake: Model: Color: Year:------License Plate Number/State: _

Additional Occupants: List everyone, including children, who will live with you.Full Name Relationship to Applicant

Rental History: First-time renters: attach a description of your housing situation for the past five years.Current Address: Dates Lived at Address: _Reason for Leaving: LandlordIManager: --'- _Landlord/Manager's Phone: Rent: $ Security Deposit: $ _

PreviousAddress: Dates Lived at Address:------------Reason for Leaving: LandlordIManager: _LandlordIManager's Phone: Rent: $ Security Deposit: $ _

Previous Address: Dates Lived at Address:------------Reason for Leaving: LandlordIManager: _LandlordIManager's Phone: Rent: $ Security Deposit: $ _

Employment History: Self-employed applicants: attach tax returns for the past two years.

Name andAddress of Current Employer: '--- _Phone: Name of Supervisor: Supervisor'sPhone: _Dates Employed at This Job: Position or Title: ~ _Name andAddress of Previous Employer: _

Phone: Name of Supervisor: Supervisor's Phone: _Dates Employed at This Job: Position or Title: _Attach pay stubs for the past two years, from this employer or prior employers, LF213P Rental Application 10·08

©nolo 1ZIBIEI_.nolo.com

Page 2: Rental Application

$-----------------$-----------------____________________________________ ~~ TOTAL: $ _

Income: 1.Your gross monthly employment income (before deductions):2. Averagemonthly amounts of other income (specify sources):

Bank/Financial Accounts Account Number Bankllnstitution BranchSavingsAccountCheckingAccount .Money Market or Similar Account ~ _

Credit Card AccountsMajor Credit Card: [ ] VISA [ ] Me [ [Discover Card [ [Am Ex [] Other: Balance: $ _

Issuer: Account No.: AverageMonthly Payment: $ _

Major CreditCard: [ ] VISA [ ]MC [] Discover Card [ ] Am Ex~[ ] Other: Balance: $ _

Issuer: Account No.: AverageMonthly Payment: $ _

LoansType of Loan(mortgage, car, student loan, etc.)

Name of Creditor . Account Number Amount Owed Monthly Payment

Other Major ObligationsType Payee Amount Owed Monthly Payment

MiscellaneousDescribe the number and type of pets you want to nave in the rental property: _Describe water-filled furniture you want to have in the rentalproperty: _

Do you smoke? [] yes []no Have you ever: Filed for bankruptcy? [] yes [] no How many times _Been sued? [] yes [] no How many times Sued someone else? [ ] yes [] no How many times _Been evicted?' [ ) yes [] no How many times Been convicted of a crime? [ ] yes [ ] no How many times _Explain any "yes" listed above: _

References and Emergency ContactPersonal Reference: Relationship: Phone. , _Admess:_~ -------- _

Personal Reference: Relationship: Phone: _

Admess: ~ ~----------------------Contact in Emergency: Relationship: Phone: _Address: _

Source: Where did you learn of this vacancy? ~~ _

I certify that all the information given above is true and correct and understand that my lease or rental agreement may be terminated if I havemade any material false or incomplete statements in this application. I authorize verification of the information provided in this application frommy credit sources, current and previous landlords and employers; and personal references. I give permission for the landlord or its agent to obtaina consumer report about me for the purpose of this application, to.ensure that I continue to meet the terms of the tenancy, for the collection andrecovery of an>:financial obligations relating to my tenancy, or for any other permissible purpose.

Applicant _--,.-----~-..:..---,--__,_---:..------.,_

Notes (Landlord/Manager): -..:..__ -"--__ -'-- ...;,.- --'- _

Dare -..:.. -'-- _