TENANT APPLICATION

Property in which interested ______________________________

Applicant name _________________________ DOB __________

Social Security # ____________ Driver's License # ____________

Other resident _________________________ DOB __________

Social Security # ____________ Driver's License # ____________

Present address ______________________________ Own __ Rent __

City ____________________ State _________ Zip ____________

Landlord name ____________________ Address ____________________

Landlord phone ____________________ Current monthly rent __________

Tenancy began __________ Reason for moving _________________________

Applicant 1: Present employer ____________________ Phone __________

Employed as ____________________ Salary _______________

Other income $____________ Source _________________________

Credit card: Issuer ____________________ Acct. # ____________________

Bank ______________________________ Acct. # ____________________

Applicant 2: Present employer ____________________ Phone __________

Employed as ____________________ Salary _______________

Other income $____________ Source _________________________

Credit card: Issuer ____________________ Acct. # ____________________

Bank ______________________________ Acct. # ____________________

Automobile #1 make & model _______________ Year _____ Color _____

License # ____________________ State of Registry ____________________

Automobile #2 make & model _______________ Year _____ Color _____

License # ____________________ State of Registry ____________________

Nearest relative: Name _________________________ Relationship _____

Address _________________________ City __________ State/Zip __________

Phones: Home ____________________ Work ____________________

Other emergency contact: Name _________________ Relationship _____

Address _________________________ City __________ State/Zip __________

Phones: Home ____________________ Work ____________________

Has any civil judgement been entered against you for the collection of a debt in the past five (5) years? ....................................... Yes ___ No ___

Have you ever been evicted? .......................................... Yes ___ No ___

Do you have any water-filled furniture or do you intend to get any in the future? ..................................................................... Yes ___ No ___

Do you have any pets or do you intend to get any pets? Yes ___ No ___

Does anyone in this household smoke? .......................... Yes ___ No ___

Explain any “Yes” above (use extra sheet if necessary) _______________________________________________________________________


AUTHORIZATION TO VERIFY INFORMATION: The undersigned authorizes Landlord or Agent to verify the above information, including but not limited to obtaining a Credit Report. I hereby declare under penalty of perjury that the above information is true and correct.

Date _______________ Signature of applicant _________________________

Home phone _______________ Work phone _______________ E-mail _______________

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