Preview Residential Lease Application

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Received on _____________________(date)

at _____________________(time)

by __________________ (initials)

Residential Lease Application

Each occupant and co-applicant 18 years or older must submit a separate application

Property Address: _________________________________________________________

Anticipated Move in Date:___________________ Monthly Rent:___________

Security Deposit:_________________

Applicant was referred to Landlord by:

□ Real Estate Agent _______________________________________________

□ Newspaper □ Sign □ Internet □ other__________________________

Applicant’s name (First, Middle, Last) ________________________________________

Is there a co-applicant? □ yes □ no

(if yes, co-applicant must submit a separate application)

Applicants former last name (maiden or married) ________________________________

E-mail: ________________________________ Home Phone______________________

Work Phone: ___________________________ Cell Phone:________________________

Emergency Contact Name & No. ____________________________________________

Marital Status ____________________ Citizenship __________________ (country)

Social Security No. _____________________________

Drivers License No ______________________ In _________________ (state)

Date of Birth ______________________ Height _________ Weight________

Eye Color ____________ Hair Color ____________

Name all other persons who will occupy the Property:

Name: ______________________________ Relationship: ______________ Age______

Applicants current address: _____________________________ apt # _____________

_____________________________________(city, state, zip)

Landlords name: _________________________________________________________

Landlords phones: _________________ (day) _____________________________(night)

_________________(cell) ____________________________(email)

Date moved-in _________________ Move out date _________________ Rent $______

Reason for move_________________________________________________________