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Home Lease Application

Lease Application

Name of Resident *

First

Last

If another resident will be renting the premises, he or she will need to complete a separate rental application form.

Date of Birth *

Driver's License Number *

Desired Date of Occupancy *

Lease Option Fee *

How much are you able to put down up front for the house?

Monthly Rent *

How much are you able to pay on a monthly basis?

Vehicle Year, Make, and Model *

License Plate Number *

Vehicle #2 Year, Make, and Model

Vehicle #2 License Plate Number

How many total occupants will be living in the home?

Selected Value: 0

Check any pets you have ($25/mo fee for dogs, cats, or other large animals) *

Dog(s)
Cat(s)
Bird(s)
Other
No pets

If Other, what kind of pet(s)?

Do you or anyone else living in the home smoke or vape? *

Yes
No

What is your present address? *

How long have you been at this address? *

What is your home phone number? *

What is your email address? *

If you currently rent, what is your Landlord's name and phone number?

How much do you pay per month in rent or mortgage?

How much income do you make in wages or salary per month? *

If any other adults will be signing the lease, how much income per month do they make? (Enter 0 if no other adults) *

How much income do you receive from government assistance or child support/alimony per month? *

Do you have any other recurring income? If yes, how much per month?

Who is your current employer? *

What is your position? *

How long have you been working for this employer? *

What is your supervisor's name? (If self-employed, type in your own name) *

First

Last

What is your supervisor's phone number? *

Personal Reference #1 (Include first and last name, phone number, and home address) *

Personal Reference #2 (Include first and last name, phone number, and home address) *

Bank References (Include bank name and branch phone number) *

Bank account information will be used for automatic withdrawal of monthly payments.

Have you ever been evicted from any rental premises? *

Yes
No

If yes, please explain:

Have you ever willfully and intentionally refused to pay rent when due? *

Yes
No

If yes, please explain:

Are there any circumstances which may interrupt your income or ability to pay rent? *

Yes
No

If yes, please explain:

Have you ever been convicted of a felony? *

Yes
No

If yes, please explain:

Have you ever filed for bankruptcy? *

Yes
No

If yes, please explain:

Other Tenant Information (Please provide the name of another tenant, including children and anyone who will live with you, even if on a temporary basis.)

Be sure to include the tenant's name, phone number (if applicable), age, relationship to primary resident, and occupation/school.

Other Tenant Information (Please provide the name of another tenant, including children and anyone who will live with you, even if on a temporary basis.)

Be sure to include the tenant's name, phone number (if applicable), age, relationship to primary resident, and occupation/school.

Other Tenant Information (Please provide the name of another tenant, including children and anyone who will live with you, even if on a temporary basis.)

Other Tenant Information (Please provide the name of another tenant, including children and anyone who will live with you, even if on a temporary basis.)

Be sure to include the tenant's name, phone number (if applicable), age, relationship to primary resident, and occupation/school.

Other Tenant Information (Please provide the name of another tenant, including children and anyone who will live with you, even if on a temporary basis.)

Be sure to include the tenant's name, phone number (if applicable), age, relationship to primary resident, and occupation/school.

The Applicant understands that the Landlord may perform a credit check to verify the Applicant's credit references and credit history in connection with the processing of this Rental Application. *

I agree

I represent that the information provided in this Application is true and correct to the best of my knowledge. The Landlord is authorized to verify the references and employment information given in this Application and to request a credit check. I acknowledge receipt of a copy of this application. *

I agree

Please type in your full name to agree to the terms of this rental application. *

IT IS AGAINST THE LAW TO DISCRIMINATE AGAINST PROSPECTIVE TENANTS ON THE BASIS OF RACE, RELIGION, NATIONAL ORIGIN, AGE, DISABILITY OR FAMILY STATUS. LOCAL OR STATE LAWS MAY INCLUDE ADDITIONAL CLASSES WHICH ARE PROTECTED FROM DISCRIMINATION IN HOUSING.

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