Application For Rent

  • Personal Information
  • Residence History
  • Employment and Income History
  • Credit Information
  • Personal References

Personal Information

Application to rent property at (required)

Full name of applicant (required)

Date of birth

Social security No.

Driver's license No.

Phone number (required)

Your Email Address (required)

Name(s) of all other proposed occupant(s) and relationship to applicant

Pet(s) or service animals (number and type)

Does applicant or any proposed occupant plan to use liquid-filled furniture? YesNo Type:

Has applicant been a party to an unlawful detainer action or filed bankruptcy within the last seven years? YesNo If yes, Explain

Has applicant or any proposed occupant ever been convicted of or pleaded no contest to a felony? YesNo If yes, Explain

Has applicant or any proposed occupant ever been asked to move out of a residence?YesNo If yes, Explain

Residence History

Current Address (required)

From:   To:

Name of Landlord/Manager (required)

Do you own this property? YesNo

Reasons for leaving current address

Previous address:

From:   To:

Name of Landlord/Manager:

Did you own this property? YesNo

Reasons for leaving current address

Employment and Income History

Current Employer's Name (required)

Employer's Address (required)

Position or Title

Employment gross income $
per

Supervisor (required)

Supervisor's Phone Number (required)

Credit Information

Please list outstanding debt

1st Creditor

Name of creditor:

Account number:

Monthly Payment:

Balance Due:

2nd Creditor

Name of creditor:

Account number:

Monthly Payment:

Balance Due:

3rd Creditor

Name of creditor:

Account number:

Monthly Payment:

Balance Due:

Bank Account Information

Bank #1

Name of Bank:

Account Number:

Type of Account:

Account Balance:

Bank #2

Name of Bank:

Account Number:

Type of Account:

Account Balance:

Personal References

Person #1

Name:

Address:

Phone Number:

Length of acquaintance:

Relation to applicant:

Person #2

Name:

Address:

Phone Number:

Length of acquaintance:

Relation to applicant:

Questions?

By typing my name and initials below, I authorize Michael Berdelis's office to run my credit, to determine my credit worthiness, and I acknowledge that the information provided in this application is true under penalty of perjury.

Full name: Initials:

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