Leasing Application

Name*
First Middle Last
Other Names Used In The Last 10 Years
First Middle Last
Date of Birth
MM slash DD slash YYYY
Social Security No.*
Home Phone
Cell Phone
Email*
Additional Occupants
Additional Occupant 1
First Middle Last
Additional Occupant 2
First Middle Last
Additional Occupant 3
First Middle Last
Employment
Current Employment
Employer
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Job Title
Name of Supervisor
Date
To
MM slash DD slash YYYY
From
MM slash DD slash YYYY
Income per month
Prior Employment
Employer
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Job Title
Name of Supervisor
Date
To
MM slash DD slash YYYY
From
MM slash DD slash YYYY
Income per month
Residence
Current Residence
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Owner/Manager Name
Owner/Manager Phone Number
Dates of Stay
To
MM slash DD slash YYYY
From
MM slash DD slash YYYY
Last Paid Rent
Reason for Leaving
Previous Residence
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Owner/Manager Name
Owner/Manager Phone Number
Dates of Stay
To
MM slash DD slash YYYY
From
MM slash DD slash YYYY
Last Paid Rent
Reason for Leaving
Vehicles
Automobiles
Make
Model
Color
Year
License No.
Motorcycles
Make
Model
Color
Year
License No.
Personal References
In Case of Emergency, Notify
Phone
Relationship
Address
Credit Information
Name of Bank or Savings & Loan
Address
Checking
Account No.
Balance
Savings
Account No.
Balance
General Information

Check all that applies
Do You Smoke?
- Yes
- No
Do You Have Any Pets?
- Yes
- No
Have you ever filed for bankruptcy?
- Yes
- No
Do you have any musical instruments?
- Yes
- No
Do you have any water-filled furniture or do you intend to use a water-filled furniture in the apartment?
- Yes
- No
Have you ever been convicted for selling, possessing, distributing, or manufacturing illegal drugs or convicted of any other crime?
- Yes
- No
Have you ever been evicted for non-payment of rent or any other reason?
- Yes
- No
Please explain any "yes" to the above questions.
Why are you leaving your current residence?
Applicant represents that all information given on this application is true and correct. Applicant hereby authorizes verification of all references and facts, including but not limited to current and previous landlords and employers, and personal references. Applicant hereby authorizes owner/agent to obtain Unlawful Detainer, Credit Reports, Telechecks, and/or criminal background reports. Applicant agrees to furnish additional credit and/or personal references upon request. Applicant understands that incomplete or incorrect information provided in the application may cause a delay in processing which may result in denial of tenancy. Applicant hereby waives any claim and releases from liability any person providing or obtaining said verification or additional information.
Applicant (signature required)
Date
MM slash DD slash YYYY
Signature

Leasing Application

Additional Occupants

Employment

Current Employment

Date

Prior Employment

Date

Residence

Current Residence

Dates of Stay

Previous Residence

Dates of Stay

Vehicles

Automobiles

Motorcycles

Personal References

Credit Information

Checking

Savings

General Information