Residential Lease ApplicationPlease enable JavaScript in your browser to complete this form.Date & Time *FirstLastProperty Address: *Anticipated: Move-in Date / Monthly Rent / Security Deposit *FirstMiddleLastInitial Lease Term Requested: (months)Property Condition: Applicant is strongly encouraged to view the Property prior to submitting any application. Landlord makes no express or implied warranties as to the Property’s condition. Applicant requests Landlord consider the following repairs or treatments should Applicant and Landlord enter into a lease:Applicant was referred to Landlord by:Real estate agentNewspaperSignInternetOtherReal estate agent: (if applicable)FirstLastOther: (if applicable)Applicant's name (first, middle, last) *FirstMiddleLastIs there a co-applicant?YesNoIf yes, co-applicant must submit a separate application.Applicant’s former last name (maiden or married):E-mail & Home PhoneFirstLastWork phone & Mobile/PagerFirstLastSocial & Driver's License & State of DLFirstMiddleLastDate of Birth & Height & WeightFirstMiddleLastEye Color & Hair Color & Marital StatusFirstMiddleLastCitizenship (country)Emergency Contact: *FirstLastName & AddressFirstLastPhone & E-mailName all other persons who will occupy the Property: *FirstMiddleLastFirstMiddleLastFirstMiddleLastFirstMiddleLastApplicant's Current Address: *FirstLastFirstMiddleLastLandlord or Property Manager: *FirstLastFirstMiddleLastFirstMiddleLastReason for move:Applicant's Previous Address: *FirstLastFirstMiddleLastLandlord or Property Manager: *FirstLastFirstMiddleLastFirstMiddleLastReason for move:Applicant's Current Employer *AddressFirstMiddleLastSupervisor *FirstMiddleLastStart Date / Gross Monthly Income $ / Position *FirstMiddleLastNote: 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.Applicant's Previous Employer *AddressFirstMiddleLastEmployed from:FirstLastGross Monthly Income $ / PositionFirstLastDescribe other income Applicant wants considered:List all vehicles to be parked on the Property:Type / Year / Make / Model / License Plate No. / State / Monthly PaymentWill any pets (dogs, cats, birds, reptiles, fish, and other pets) be kept on the Property? *YesNoPet #1 DetailsFirstMiddleLastType & Breed Name / Color / WeightFirstLastAge in Yrs / Gender / Neutered?Check all that apply:Neutered?Declawed?Shots Current?Bite History?Pet #2 DetailsFirstMiddleLastType & Breed Name / Color / WeightFirstLastAge in Yrs / Gender / Neutered?Check all that apply:Neutered?Declawed?Shots Current?Bite History?Pet #3 DetailsFirstMiddleLastType & Breed Name / Color / WeightFirstLastAge in Yrs / Gender / Neutered?Check all that apply:Neutered?Declawed?Shots Current?Bite History?Additional Pets? Explain here:Will any waterbeds or water-filled furniture be on the Property?YesNoDoes anyone who will occupy the Property smoke?YesNoWill Applicant maintain renter’s insurance?YesNoIs Applicant or Applicant’s spouse, even if separated, in military?YesNoIf yes, is the military person serving under orders limiting the military person’s stay to one year or less?Has Applicant ever: (check all that apply) *been evicted?been asked to move out by a landlord?breached a lease or rental agreement?filed for bankruptcy?lost property in a foreclosure?had any credit problems, including any outstanding debt (e.g., student loans or medical bills), slow-pays or delinquencies?been convicted of a crime? If yes, provide the location, year, and type of conviction below.Is any occupant a registered sex offender? If yes, provide the location, year, and type of conviction below.Is there additional information Applicant wants considered?NONE OF THE ABOVEAuthorization: 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 of $_____ to _______________ (entity or individual) for processing and reviewing this application. Applicant ___ submits ___ will not submit an application deposit of ______$ to be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed. *FirstLast1. Input fee amount 2. Input the entity or individual you are submitting the fee to.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. *FirstLast1. Signature 2. DateFor Landlord’s Use: On ________, __________ /__ __ (name/initials) notified ____________ Applicant ___ by ___ phone ___ mail ___ e-mail ___ fax ___ in person that Applicant was ____ approved ____ not approved. Reason for disapproval: *FirstLast1. Date 2. Name / Initials3. Name of Applicant phonee-mailfaxin-person4. Notified by:approvednot approved5. Approved / Not approvedReason for disapproval (if not approved):AUTHORIZATION TO RELEASE INFORMATION RELATED TO A RESIDENTIAL LEASE APPLICANT: I, (Applicant), have submitted an application to lease a property located at (address, city, state, zip). *AddressFirstMiddleLastCity / State / ZipThe landlord, broker, or landlord’s representative is: *FirstLastName / AddressFirstMiddleLastCity / State / ZipFirstMiddleLastPhone / Fax / EmailI give my permission: (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. *FirstLastApplicant's Signature / Date; Note: Any broker gathering information about an applicant acts under specific instructions to verify some or all of the information described in this authorization. The broker maintains a privacy policy which is available upon request.Submit