Residential Lease Application

Date & Time *

First

Last

Property Address: *

Anticipated: Move-in Date / Monthly Rent / Security Deposit *

First

Middle

Last

Initial 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:

Real estate agent: (if applicable)

First

Last

Other: (if applicable)

Applicant's name (first, middle, last) *

First

Middle

Last

Is there a co-applicant?

If yes, co-applicant must submit a separate application.

Applicant’s former last name (maiden or married):

E-mail & Home Phone

First

Last

Work phone & Mobile/Pager

First

Last

Social & Driver's License & State of DL

First

Middle

Last

Date of Birth & Height & Weight

First

Middle

Last

Eye Color & Hair Color & Marital Status

First

Middle

Last

Citizenship (country)

Emergency Contact: *

First

Last

Name & Address

First

Last

Phone & E-mail

Name all other persons who will occupy the Property: *

First

Middle

Last

First

Middle

Last

First

Middle

Last

First

Middle

Last

Applicant's Current Address: *

First

Last

First

Middle

Last

Landlord or Property Manager: *

First

Last

First

Middle

Last

First

Middle

Last

Reason for move:

Applicant's Previous Address: *

First

Last

First

Middle

Last

Landlord or Property Manager: *

First

Last

First

Middle

Last

First

Middle

Last

Reason for move:

Applicant's Current Employer *

Address

First

Middle

Last

Supervisor *

First

Middle

Last

Start Date / Gross Monthly Income $ / Position *

First

Middle

Last

Note: 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 *

Address

First

Middle

Last

Employed from:

First

Last

Gross Monthly Income $ / Position

First

Last

Describe other income Applicant wants considered:

List all vehicles to be parked on the Property:

Type / Year / Make / Model / License Plate No. / State / Monthly Payment

Will any pets (dogs, cats, birds, reptiles, fish, and other pets) be kept on the Property? *

Pet #1 Details

First

Middle

Last

Type & Breed Name / Color / Weight

First

Last

Age in Yrs / Gender / Neutered?

Check all that apply:

Neutered?
Declawed?
Shots Current?
Bite History?

Pet #2 Details

First

Middle

Last

Type & Breed Name / Color / Weight

First

Last

Age in Yrs / Gender / Neutered?

Check all that apply:

Neutered?
Declawed?
Shots Current?
Bite History?

Pet #3 Details

First

Middle

Last

Type & Breed Name / Color / Weight

First

Last

Age 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?

Does anyone who will occupy the Property smoke?

Will Applicant maintain renter’s insurance?

Is Applicant or Applicant’s spouse, even if separated, in military?

If yes, is the military person serving under orders limiting the military person’s stay to one year or less?

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 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. *

First

Last

1. 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. *

First

Last

1. Signature 2. Date

For 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: *

First

Last

1. Date 2. Name / Initials

3. Name of Applicant

phone
e-mail
fax
in-person

4. Notified by:

approved
not approved

5. Approved / Not approved

Reason 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). *

Address

First

Middle

Last

City / State / Zip

The landlord, broker, or landlord’s representative is: *

First

Last

Name / Address

First

Middle

Last

City / State / Zip

First

Middle

Last

Phone / Fax / Email

I 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. *

First

Last

Applicant'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.