"Tenant Application Form - Ucsb Community Housing Office" - California

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Download "Tenant Application Form - Ucsb Community Housing Office" - California

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UCSB COMMUNITY HOUSING OFFICE
University Center, Santa Barbara, CA 93106-7160
E-Mail: ucsbcho@housing.ucsb.edu
www.housing.ucsb.edu
v
Phone: 805-893-4371
ON-LINE LISTINGS v EDUCATION v DISPUTE RESOLUTION v RENTAL SUCCESS GUIDE
TENANT APPLICATION
PERSONAL INFORMATION
Name: Last
First
Middle
Phone Number:
Mailing Address:
Social Security Number:
Driver’s License # & State:
Last Rental Address:
Duration of Last Tenancy:
Reason for Moving: __________________________________________________________________________
__________________________________________________________________________________________
Name of your Last Property Provider/Manager:
Have you ever been evicted or asked to move? YES
NO Please explain: ____________________________
__________________________________________________________________________________________
Automobile – Make:
Model:
Year:
License #:
State:
LIST NAMES OF PROPOSED OCCUPANTS
1. __________________________________________
2. _________________________________________
3. __________________________________________
4. _________________________________________
Will you have pets? YES
NO
Describe:
SOURCE OF INCOME (%)
$ __________________
$ __________________
$ __________________
$___________________
Part-Time Job(s)
Self-Employed
Parental Support
Grants/Loans
If Employed…
Name of Employer/Supervisor:
Phone Number:
Employer’s Company & Address:
Sample Form
41
UCSB Community Housing Office / www.housing.ucsb.edu
UCSB COMMUNITY HOUSING OFFICE
University Center, Santa Barbara, CA 93106-7160
E-Mail: ucsbcho@housing.ucsb.edu
www.housing.ucsb.edu
v
Phone: 805-893-4371
ON-LINE LISTINGS v EDUCATION v DISPUTE RESOLUTION v RENTAL SUCCESS GUIDE
TENANT APPLICATION
PERSONAL INFORMATION
Name: Last
First
Middle
Phone Number:
Mailing Address:
Social Security Number:
Driver’s License # & State:
Last Rental Address:
Duration of Last Tenancy:
Reason for Moving: __________________________________________________________________________
__________________________________________________________________________________________
Name of your Last Property Provider/Manager:
Have you ever been evicted or asked to move? YES
NO Please explain: ____________________________
__________________________________________________________________________________________
Automobile – Make:
Model:
Year:
License #:
State:
LIST NAMES OF PROPOSED OCCUPANTS
1. __________________________________________
2. _________________________________________
3. __________________________________________
4. _________________________________________
Will you have pets? YES
NO
Describe:
SOURCE OF INCOME (%)
$ __________________
$ __________________
$ __________________
$___________________
Part-Time Job(s)
Self-Employed
Parental Support
Grants/Loans
If Employed…
Name of Employer/Supervisor:
Phone Number:
Employer’s Company & Address:
Sample Form
41
UCSB Community Housing Office / www.housing.ucsb.edu
BANK ACCOUNTS
Savings Account Number: _________________________
Bank/Branch: ______________________________
Checking Account Number: ________________________
Bank/Branch: ______________________________
CREDIT CARDS
Name of Card: __________________________________
Account #: _________________________________
Name of Card: __________________________________
Account #: _________________________________
PERSONAL REFERENCES
NAME
PHONE
RELATiONSHiP
1. _________________________________________________________________________________________
2. _____________________________________________________________________________________
IN CASE OF AN EMERGENCY, PLEASE NOTIFY
NAME
PHONE
RELATiONSHiP
1. _________________________________________________________________________________________
2. _________________________________________________________________________________________
Applicant represents that all the above statements are true and correct and hereby authorizes verification of the above
items, including, but not limited to, obtaining a credit report and agrees to furnish additional credit references upon
request. Applicant consents to allow Property Provider/Manager to disclose tenancy information to previous or
subsequent Property Providers/Managers.
Property Provider received payment from Applicant of $ _________________, which is to be used to screen
Applicant with regard to credit history and other background information. The amount charged is itemized as follows:
1. Actual cost of credit report, unlawful detainer (eviction) search, and/or other reports
$ _____________________
2. Cost of obtaining, processing and verifying screening information
$ ____________________
3. Total fee charged (may not exceed $42.06 per applicant)
$ _____________________
The undersigned is applying to rent housing accommodations designated as:
Unit: _____ Located at:___________________________________________________________________
for the Rental Amount of $ _________________ per _________________, and upon approval of this application
agrees to sign a rental or lease agreement and to pay all sums due, including required security deposit of
$ __________, before occupancy.
Applicant’s Signature: ______________________________________________ Date: ______________
Sample Form
42
UCSB Community Housing Office / www.housing.ucsb.edu
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