Date: _________________ Credit Check Fee
$_____________
Rental/Credit Application
Page 1 of 2
The undersigned hereby makes application for a rental unit located at ___________________________________
beginning on________________________________ .19 at a monthly rental at $ ______________________
and submits the following information:
Name of Applicant _____________________ Age _____ Spouse/Co.Applicant __________________ Age _____
Current Address______________________________________________ Phone ________________________
Currently : Rent ______ Own______ Parents ______ Other _______
How Long ? ____________ Reason for Leaving _________________________________________________
Landlord _______________________________________ Phone ____________________________________
Previous Address : _____________________________________________________________________________
How Long ? ____________ Reason for Leaving _________________________________________________
Landlord _______________________________________ Phone ____________________________________
Applicant Co-Applicant/Spouse
Employer ______________________________ Employer ______________________________
Address _____________ City _____________ Address ______________ City ____________
Phone______________ How Long __________ Phone_____________ How Long ___________
Type of Work ___________________________ Type at Work ___________________________
Supervisor's Name _______________________ Supervisor's Name ______________________
Weekly/Monthly Income ___________________ Weekly/Monthly Income ___________________
Previous Employer Previous Employer
if less than two years ___________________________ if less than two years ________________________
____________________________________________ _________________________________________
Automobile Make. Model, Year __________________ Automobile Make. Model, Year ________________
Automobile License Number ____________________ Automobile License Number __________________
State of Registry ______________________________ State of Registry ____________________________
Drivers License # ______________________________ Drivers License # ___________________________
Social Security # ______________________________ Social Security # ___________________________
Name at Bank ________________________________ Name of Bank ______________________________
Account # ___________________________________ Account # _________________________________
Credit References and Credit Cards Credit References and Credit Cards
Name Account Number Name Account Number
___________________________________________ __________________________________________
___________________________________________ __________________________________________
___________________________________________ __________________________________________
Names/Addresses of two closest relatives: Names/Addresses of two closest relatives:
___________________________________________ __________________________________________
___________________________________________ __________________________________________
___________________________________________ __________________________________________
Who do we notify in case of emergency: Name _____________________ Address : ______________________
___________________________Phone ________________________
Dependents
Names/Ages ________________________________ Pet(s) ____ Yes ____ No
___________________________________________ Kind_________________________________
___________________________________________
___________________________________________ _________________________________
___________________________________________
Other Occupants and Their Relationship _________________________________________________________
Have you ever:
Filed for bankruptcy? ( ) Yes ( ) No
been evicted or are you now being evicted from tenancy? ( ) Yes ( ) No
willfully or intentionally refused to pay rent when due? ( ) Yes ( ) No
Applicants guarantee that statements made above are correct and hereby authorize verification of information
Upon approval of application for lease and in the event applicant fails to sign lease within three days of approval or such
reason-able extensions approved by lessor. then in that event Lessor shall keep all monies deposited as liquidated damages
for lost rentals and expenses incurred
THIS APPLICATION IS NOT A RENTAL AGREEMENT. CONTRACT OR A LEASE- ALL APPLICATIONS
ARE SUBJECT TO APPROVAL OF OWNER OR MANAGING AGENT. WHO MAY INVESTIGATE MY
CREDIT. CHARACTER AND REPUTATION.
APPLICANT_______________________________ APPLICANT ______________________________
Application and Deposit of $ __________________ Date Received _____________________________
Received by ______________________________
TO BE COMPLETED BY AGENT:
Type of Unit ________________ Furnished _______________ Unfurnished ________________
Monthly Rent __________________ Security Required ________________
Electric _________ Gas ________ Heat ________ Parking _________ Other ________
Payment Received___________________ Balance Due ____________________
Rent __________________________________ Rent ___________________________
Security _______________________________ Security _________________________
Balance Due Prior To Occupancy __________________ Total Paid ________________
Lease Term: From____________ To____________ Occupancy Date ________________
Rental Agent ________________ Building Manager __________________________
CREDIT REPORT FORM
IN FILE DATE _________________
Indly. Joint Date Date High Mo. Type History Late
Acct. Acct Company Repud. Open Credit Pmt's Balance Acct. of Mo. Pmts Rating
___ ____ ________ ______ _____ _____ _____ ________ _____ ______ _____ _____
___ ____ ________ ______ _____ _____ _____ ________ _____ ______ _____ _____
___ ____ ________ ______ _____ _____ _____ ________ _____ ______ _____ _____
___ ____ ________ ______ _____ _____ _____ ________ _____ ______ _____ _____
___ ____ ________ ______ _____ _____ _____ ________ _____ ______ _____ _____
Other Inquiries: ______________________________________________________________________
___________________________________________________________________________________