EmailMe Form - RENTAL APPLICATION

Property Address:

Please enter the property address you applying for.

At a Monthly Rent Of:

Please indicate advertized rental price

Desired Move In Date: *

MM / DD / YYYY

Please indicate when you would like to start the lease

Applicant's Name: *

First Last

Applicant's Date of Birth: *

MM / DD / YYYY

Applicant's Email: *

Contact Phone:

### - ### - ####

Co-Applicant's Name (if Any):

First Last

Co-Applicant's Date of Birth:

MM / DD / YYYY

Please list all dependents and their DOB:

Please list all pets, including age, weight and breed (Put NA if none): *

PLEASE GIVE RESIDENTIAL HISTORY.
What is your current address. *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Date Moved In:

MM / DD / YYYY

Reason For Leaving:

Owner or Property Manager Name and Phone Number:

PLEASE DESCRIBE YOUR CREDIT HISTORY:
(check for YES)

Have you declared Bancruptsy in the past 7 years?

Have you ever been evicted from rental property?

Have you two or more late rental payments?

Have ever intentionally refused to pay rent when due?

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION:

Employer Name: *

Put NA if unemployed

Employment Status: *

Employer Address:

Street Address City State / Province / Region Postal / Zip Code

Employed Since:

MM / YY

Position: *

Annual Salary: *

$ Dollars

Supervisor Name:

Supervisor Phone Number:

### - ### - ####

Additional Income (here you can indicate Co-Applicant's Income, SSI, Child Support, Etc):

Please indicate all additional income to support your application

PLEASE PROVIDE YOUR REFERENCES: *

You Must Indicate at Least One Personal Reference or Emergency Contact (Name, Relationship and Phone Number):

PLEASE PROVIDE YOUR VEHICLE INFORMATION:

Please List All Vehicles you Have (Year, Make, Model, Plate Number)

Please give us any additional information that might help owner/management evaluate this application:

WHERE MAY WE REACH YOU TO DISCUSS YOUR APPLICATION?:

Email or phone please.

PLEASE READ STATEMENT BELOW CAREFULLY
When Done-Please Sign In Your Name and date *

First Last

I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application. When so approved and accepted, I agree to execute a lease for 12 months before possession is given and to pay the balance of the security deposit prior to the move in date. If the application is not approved or accepted by the owner or agent, the deposit will be refunded, the application hereby waiving any claim for damages by reason of non-acceptance which the owner or agent may reject. I recognize that as a part of your procedure for processing my application, and investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. The above information, to the best of my knowledge, is true and correct.

AUTHORIZATION Release of Information
I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house, apartment, or condominium from this owner/manager.
By clicking submit button you stating, to the best of your knowledge, information provided above is true and correct and agree to the Terms and Conditions of this application:

Today's Date: *

MM / DD / YYYY