"Rental / Credit Application Form"

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Rental / Credit Application
PERSONAL INFORMATION
Date ___________________________________________ Interviewed By _______________________________________________
Name of Applicant _________________________________________________ Date of Birth ________________________________
E-mail ____________________________________________ Telephone ___________________________________________________________
Social Sec. No. ________________________________________________ Driver’s License No. _________________________________
Present Address _________________________________________ City _____________________ State _________ Zip ___________
Prior Address _________________________________________ City _____________________ State _________ Zip____________
How long have you lived at present address?_________________ How long have you lived at prior address? _________________________
Name of Landlord __________________________________________ Telephone __________________________________________
Prior Landlord_____________________________________________ Telephone _____________________________________________
How many will be living in this unit? Adults_____________ Children ____________ Pets ___________ Weight of pets ____________
Employer _________________________________________ Occupation ___________________________ Current Salary __________
How long?____________________________ Contact Person ____________________________ Telephone ________________________
SPOUSE INFORMATION
Name of Spouse __________________________________________ Date of Birth ______________ Telephone __________________
Social Sec. No. __________________________________________ Driver’s License No. _________________________________________
Employer ____________________________ Occupation ____________________________ Current Salary ________________________
How long? ____________________________ Contact Person ____________________________ Telephone _____________________
Has your spouse ever filed for bankruptcy?
q
Yes
q
No
BANK INFORMATION
Bank Name _________________________________________________ Branch ___________________ Telephone _________________
_____
Address
______________________________________________________________________________________________
________________________________
Checking Account No.
Savings Account No. _______________________________________
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© 2004, Socrates Media, LLC
LF305 • Rev. 04/04
Rental / Credit Application
PERSONAL INFORMATION
Date ___________________________________________ Interviewed By _______________________________________________
Name of Applicant _________________________________________________ Date of Birth ________________________________
E-mail ____________________________________________ Telephone ___________________________________________________________
Social Sec. No. ________________________________________________ Driver’s License No. _________________________________
Present Address _________________________________________ City _____________________ State _________ Zip ___________
Prior Address _________________________________________ City _____________________ State _________ Zip____________
How long have you lived at present address?_________________ How long have you lived at prior address? _________________________
Name of Landlord __________________________________________ Telephone __________________________________________
Prior Landlord_____________________________________________ Telephone _____________________________________________
How many will be living in this unit? Adults_____________ Children ____________ Pets ___________ Weight of pets ____________
Employer _________________________________________ Occupation ___________________________ Current Salary __________
How long?____________________________ Contact Person ____________________________ Telephone ________________________
SPOUSE INFORMATION
Name of Spouse __________________________________________ Date of Birth ______________ Telephone __________________
Social Sec. No. __________________________________________ Driver’s License No. _________________________________________
Employer ____________________________ Occupation ____________________________ Current Salary ________________________
How long? ____________________________ Contact Person ____________________________ Telephone _____________________
Has your spouse ever filed for bankruptcy?
q
Yes
q
No
BANK INFORMATION
Bank Name _________________________________________________ Branch ___________________ Telephone _________________
_____
Address
______________________________________________________________________________________________
________________________________
Checking Account No.
Savings Account No. _______________________________________
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© 2004, Socrates Media, LLC
LF305 • Rev. 04/04
PERSONAL / CREDIT REFERENCES
NAME
RELATIONSHIP
TELEPHONE
_____________________________________________ ___________________________________
___________________
_____________________________________________ ___________________________________
___________________
_____________________________________________ ___________________________________
___________________
CREDIT GRANTOR
ADDRESS
TELEPHONE
_____________________________________________ ___________________________________
___________________
_____________________________________________ ___________________________________
___________________
_____________________________________________ ___________________________________
___________________
_____________________________________________ ___________________________________
___________________
_____________________________________________ ___________________________________
___________________
OTHER INFORMATION
Number of vehicles (including company cars) _______________________________________________________________________
Make/Model______________________________________ Year_______ Color __________ Tag No. ______________ State _______
Make/Model______________________________________ Year_______ Color __________ Tag No. ______________ State _______
Make/Model______________________________________ Year_______ Color __________ Tag No. ______________ State _______
HAVE YOU EVER
q
q
Filed for bankruptcy
Yes
No
If yes, when? ______________________________________________________
q
q
Been served an eviction notice or been asked to vacate a property you were renting?
Yes
No
q
q
Willfully or intentionally refused to pay rent when due?
Yes
No
If yes, when?____________________________________
q
q
Been sued for unlawful detainer?
Yes
No
q
q
q
How were you referred to us?
Newspaper (name) ________________
Realtor (name) ____________
Other ______________
Rental Unit applied for__________________________________________________________________________________________
Commencement date ________________________ Term _____________________ Rent/Month _______________________
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© 2004, Socrates Media, LLC
LF305 • Rev. 04/04
ACKNOWLEDGEMENT
I/We, the undersigned, understand that __________________________________ is the leasing agent and representative for the owner/land-
lord and that the leasing agent’s fees will be paid by the owner/landlord. The undersigned acknowledge that this written notice was received prior
to the undersigned receiving a lease agreement.
________________________________________________
______________________________________________
Applicant’s Signature
Date
Co-Applicant’s Signature
Date
CONSENT TO OBTAIN CREDIT / EMPLOYMENT INFORMATION
I/We authorize __________________________________, to investigate my/our credit qualifications and hereby release, in any manner,
all of the information obtained by you. I/We further release all persons, agencies, or firms from any liabilities resulting from providing such
information.
I/We declare under penalty of perjury that the information listed in this application is true and correct.
Executed on this ________ day of _________________________, 20_____, in the city of __________________, state of __________.
________________________________________________
____________________________________________
Applicant’s Signature
Date
Co-Applicant’s Signature
Date
The undersigned authorizes landlord, leasing agent, and representatives of owner/landlord to contact the undersigned's current or previous
landlord, and current employer, and further, by a copy of this Application, authorizes any said landlord or employer to release pertinent residential
and employment history information to be used in evaluating my lease application. I further authorize owner/landlord, leasing agent or its
representatives to apply for or obtain an investigation or credit report in connection with this application. I understand that said investigation
or credit report may contain information obtained from various state governmental and private entities relative to the undersigned's number of
children, employment, occupation, general health, financial, and criminal history information.
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© 2004, Socrates Media, LLC
LF305 • Rev. 04/04
FOR OFFICE USE ONLY – DO NOT WRITE BELOW
Application Verification
Person Contacted
Remarks
q Present Landlord
q Previous Landlord
q Applicant’s Employment
q Co-Applicant’s Employment
q Bank
q Reference (1)
q Reference (2)
q Reference (3)
q Other
q Driver’s License/ID
q Credit Bureau
Verification completed by: _______________________________
MONIES RECEIVED
Date: ______________________________________________
Date
Description
Amount
Application Fee
Remarks: ___________________________________________
Security Deposit
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
q
q
__________________________________________________
THIS APPLICATION:
Is Approved
Is Not Approved
Page 4
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© 2004, Socrates Media, LLC
LF305 • Rev. 04/04
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