Rental Application for 
(address)_______________________ 
Name_____________ Phone_____________ Work 
Phone_____________ 
Social Security No._______/______/______ 
Drivers Lic. No.________________________ 
Date of Birth____/____/_____ 
Present 
Address_______________________________________________ 
How long at this 
address?______ Rent $______ 
Reason for moving_____________________________________ 
Owner/Manager_______________________ 
Phone__________________ 
Previous 
Address_______________________________________________ 
How long at this 
address?______ Rent $______ 
Reason for moving_____________________________________ 
Owner/Manager_______________________ 
Phone__________________ 
Name and relationship of every person to live with you, 
even if only temporarily (include ages of minors): 
1.)______________________relationship____________age___
2.)______________________relationship____________age___
3.)______________________relationship____________age___
4.)______________________relationship____________age___ 
Any pets?_______ Describe_____________________________
Waterbed?_______ 
Present 
Occupation______________ Employer_________________
Address of Employer_______________________________ 
Phone___________________
How long with this 
employer?___________________ Supervisor____________ 
Phone___________________ 
Previous 
Occupation______________ Employer__________________ 
Phone___________________
How long with this 
employer?___________________ Supervisor____________ 
Phone___________________ 
Current Gross Income Per Month (before deductions) 
$_______________ 
List sources of income (other than present employment 
listed above) 
__________________________________________________
__________________________________________________

Savings 
Account: Bank_________________ Branch_____________ 
Acct. No._____________________ 
Checking 
Account: Bank_________________ Branch_____________ 
Acct. No._____________________ 
Major Credit 
Card__________________ Acct. No.__________________ 
Expires__________ 
Credit 
Reference______ Acct. No.______ Bal. Owed_____ Mo. 
Pmt._____ 
Credit 
Reference______ Acct. No.______ Bal. Owed_____ Mo. 
Pmt._____ 
HAVE YOU 
ever filed bankruptcy?___ ever been evicted?___ or ever 
been convicted of a felony?______ Explain any 
"yes" 
answers on back. Vehicle(s) 
Make(s)__________ Model(s)__________ Year(s)__________ 
License(s)_______________
Personal 
Reference________________ Address_____________________ 
Phone____________________
Contact in 
Emergency________________ Address_____________________ 
Phone____________________
I declare that the statements above are true and correct. 
I authorize verification of my references and credit as 
they relate to my tenancy AND to future rent collections. 
Date_____________ 
Signed____________________________________ 
Verified: 
SSN__DL/ID__CurTen__Prev__Credit__Inc___Refs___By___