Rental Application First Name Middle Name Last Name Date of Birth Social Security Number Driver's License Number Other names you've used in the past Email Address Phone Number All Other Proposed Occupants Name Birth Date Relationship to Applicant Name Birth Date Relationship to Applicant Name Birth Date Relationship to Applicant Name Birth Date Relationship to Applicant Current Residence Address Rent Paid Landlord Phone # Reason for Leaving Did you give Notice? YesNo Were you asked to move? NoYes Residency begin date Residency end date Previous Residence Address Rent Paid Landlord Phone # Reason for Leaving Did you give Notice? YesNo Were you asked to move? NoYes Residency begin date Residency end date Prior Residence Address Rent Paid Landlord Phone # Reason for Leaving Did you give Notice? YesNo Were you asked to move? NoYes Residency begin date Residency end date Current Employment Employer Address Employer's Phone # Occupation Name of Supervisor Monthly Gross Pay Employment start date Previous Employment Employer Address Employer's Phone # Occupation Name of Supervisor Monthly Gross Pay Employment start date Employment end date Prior Employment Employer Address Employer's Phone # Occupation Name of Supervisor Monthly Gross Pay Employment start date Employment end date References & Emergency Contacts Reference 1 Name Address Phone # Reference 2 Name Address Phone # Nearest Relative Living Elsewhere Name Address Phone # By submitting the application, you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you. Furthermore, if you abandon the apartment for any reason then you grant us permission to allow your relative listed above to remove all the contents of the dwelling on your behalf. Have you ever been served a late rent notice? NoYes Do any of the people who would be living in the apartment smoke? NoYes How long do you think you would be renting from us? Have you ever filed for bankruptcy? NoYes If you have filed for bankruptcy, when? When would you be able to move in? Have you ever been convicted of a felony? NoYes Have you ever been served an eviction notice? NoYes If you have been served an eviction notice, when? Do you have any pets? (List Type, Breed, Weight & Age) Have you had any reoccurring problems with your current apt./landlord? If yes, explain: Why are you moving from your current address? If you were to run into financial difficulty, do you know someone who would loan you the money to pay your rent? If so, please prove that persons information so we can use them as a reference for you. Have you been a party to a lawsuit in the past? If yes, please explain why: Do you consent to a credit/criminal background check? YesNo How did you hear about this apartment? Agreement & Authorization I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal background check to be made, verification of information I provided and communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for an apartment and does not constitute a rental or lease agreement in whole or part. Yes, I Accept Today's Date Δ
