APPENDIX A: SAMPLE RENTAL APPLICATION

Applicant’s Full Name____________________ Spouse’s Name___________________

Applicant’s Soc. Sec. # _____-____-_____ Spouse’s Soc. Sec. # ____-____-____

Driver’s License # ______________________ What State? _____

Present Address ________________________________________________________

Street City State Zip

How long at present address _____________ Phone Number _______________

Amount of rent currently paying ___________ Reason for Moving ____________

List last 3 landlords and phone numbers 1) __________________ ___________

2) ___________________ __________ 3) __________________ ___________

Employed by ____________________________ How long? _____________________

Position ____________ Work Phone # _________ Gross Salary Per Month _________

Total of other income per month _______________________________________

Other residents who will reside with you and their relationship to you: ____________

______________________________________________________________________

Do you have any pets? Yes __ No__ If yes, what kind? ____________________

In case of an emergency notify: _______________________ ____________________

Name Phone Number

Credit References 1) _______________________________________________

Bank/Credit card 2) ________________________________________________

**Personal References 1) __________________________ Phone # __________

2) __________________________ Phone # __________

**These could be Supervisors at work or non-relative friends.

WE WILL RUN A CREDIT CHECK ON THIS APPLICATION THROUGH THE LOCAL CREDIT BUREAU AND WE WILL ALSO RUN THIS APPLICATION THROUGH THE RENTER’S DIRECTORY SYSTEM. ANY FALSE STATEMENT WILL BE CAUSE FOR IMMEDIATE REJECTION OF THIS APPLICANT.

I, __________________________, give _____________________ permission to

 

verify the information given on the application.

Applicant’s Signature

Landlord

Date ___/___/___