Sample Form
Rental Application
(Subject to Owner's Approval)
Name of Applicant Home Phone Initial if over 18 yrs of age
Present Address Dates of Current
Occupancy:
To: Mo. Yr.
City State Automobile Make&Yr
Reg (State&No.)
Social Security #
Present Landlord Complete Address Phone Number
Former Landlord Occupancy ___ Years Complete Address Phone Number
Current Employer Complete Address Phone Number
Occupation or Source of Income Type of Business Salary Length of Employment
Former Employer Length of employment Complete Address Phone Number
Personal Reference (Name) Complete Address Phone Number
In Case of Emergency Notify (Name) Complete Address Phone Number
Credit Reference Complete Address Phone Number
Bank-Checking Account Branch Address Account Number
Bank-Savings Account Branch Address Account Number
Names of all co-tenants (each adult must file a separate application)
Apartment No. Or
Type
Total Number of
Occupants
Number of Adults Pets Base rent per month $_____
(Subject to escalation as set
for in lease)
Address Names&Ages of Minor Children
Other Monthly charges_____
Placement Fee_______
City Occupancy Date Rent Begins
Last Month's Rent ________
Terms of lease
(months)
From (Date) To (Date) Security Deposit________
Deposit on Account
Base rent&other monthly charges are due & payable on the first day of each month in advance Balance Due Upon
Acceptance __________