PRINTABLE RENTAL FORM
APPLICANT INFORMATION
Name: _________________ SSN: ____________________
Date of Birth: ___________________ Phone: __________________
Current Address: __________________________
Email: ____________________ Driver’s License: ______________
❑ Own ❑Rent Monthly Rent: ______________ Duration: ________________
Landlord’s Name: __________________
Previous Address: APPLICANT’S STREET ADDRESS, APPLICANT’S CITY, APPLICANT’S STATE,
APPLICANT’S ZIP CODE
❑ Own ❑ Rent Monthly Rent: ____________ Duration: _____________
Landlord’s Name: __________________
PROPOSED OCCUPANTS
Name: ________________ Date of Birth: ___________________
Relationship: _______________
Name: ________________ Date of Birth: ___________________
Relationship: _______________
Name: ________________ Date of Birth: ___________________
Relationship: _______________
Do you smoke? ❑ Yes ❑No Occupants? ❑ Yes ❑ No
Pets? ❑ Yes ❑ No Number of Pets: ____________ Type: _______
EMPLOYMENT INFORMATION
Current employer: ________________ Title: __________
Employer’s address: ____________________ Duration: _____________
Phone: ________________ Email: _____________
Gross Income: _______________
Previous employer: _______________ Title: ___________
Employer’s previous address: _______________________ Duration: ____________
Phone: _____________ Email: _____________
Gross Income: _________________
REFERENCES
Full name: _____________________ Relationship: ________________
Phone: _____________ Email: __________________
Full name: _____________________ Relationship: ________________
Phone: _____________ Email: __________________
FINANCIAL INFORMATION
Bank Name 1: ______________ Branch: _______________
Contact Number: _______________
Checking Account No.: ____________ Savings Account No.: ____________
Bank Name 2: ______________ Branch: _______________
Contact Number: _______________
Checking Account No.: ____________ Savings Account No.: ____________
1st Credit Reference: _________________
Address: __________________ Contact Number: _______________
2nd Credit Reference: _________________
Address: __________________ Contact Number: _______________
CONSENT
I/We, ___________________, justify that the information provided in this Application is true
and correct to the best of my/our knowledge. Any false information provided by me/us shall be
grounds for rejection of this Application or termination of Lease Agreement with the Landlord
or the Property Manager. I/We hereby authorize the Landlord, ________________, to review
my/our credit and criminal history and perform a background check to ensure the validity of
the abovementioned confidential information. I/We further authorize banks, creditors, credit
card companies, references, and all other persons or entities to provide the Landlord any and
all information pertaining to my/our financial information. I/We acknowledge that incorrect or
incomplete information shall be grounds for the rejection of this Application.
Applicant’s Signature: _______________ Date: _____________