RENTAL APPLICATION for house or apartment at ______________________________________________ Date you wish your lease to start _______________________________ A separate application is required for each individual over 18 years old. Complete both pages/sides. Applicant's First Name _____________ Middle Name_____________ Last Name__________________ Age ____ Date of Birth _______ Soc Sec No ______________ Driver license number___________________________________ State____ Marital Status_______________ Email address ______________________________Phone ________________________________ Name and ages all other adult and children co-residents of premises _________________________________________________________________________________________ _________________________________________________________________________________________ Description of pets, including size and age of dogs, and ages of cats:_________________________________ _________________________________________________________________________________________ Current Address (Street, City and State) _________________________________________________________________________ Dates of residence at this address ________________________________ Landlord/agent: Name: ________________________ Address: _____________________________________ Phone: _________________________________ Email: ____________________________ Current rent _____________ Lease Start Date ________________ Lease end date ____________ Reason for moving _________________________________________________________________ Currently behind in rental payments? ___________ If so, how much? ______________ Ever behind in rental payments? ___________ If so, how much? ______________ Address prior to current (Street, City and State) ____________________________________________________________________ Dates of residence at this address ________________________________ Landlord/agent: Name: ________________________ Address: ____________________________________ Phone: __________________________________ Email: _________________________________ Last rent amount at this address ________Last Lease Start Date _______ Last Lease end date ____________ Reason for moving _________________________________________________________________ Ever behind in rental payments? ___________ If so, how much? ______________ Applications without answers to all of (i)-(v) in the following question will not be reviewed. Have your ever (i) filed for bankruptcy?___ (ii) been evicted?_____ (iii) broken a rental or lease agreement? _____ (iv)convicted of a felony? ______ (v) been sued for nonpayment of rent or for damages to rental property? ______ If you answered yes to any of (i) to (v), provide dates and an explanation at the bottom of this application. List all vehicles which may be parked on or near premises Type of vehicle___________________ Make,model,year_______________ License__________ State_____ Type of vehicle___________________ Make,model,year_______________ License__________ State_____ Type of vehicle___________________ Make,model,year_______________ License__________ State_____ If attending school, what school, what degree or certification are you seeking, what subject or specialty, expected graduation date? __________________________________________________________________________________________ Employment(s) of Applicant Primary employment name/address (Street, City and State) ___________________________________________________________ Position_________________________________ Salary____________ Starting Date _____________ Hours/wk________ Months/year_________ Supervisor Name ____________________ Phone _________________ Email _______________________ Previous employer name address _______________________________________ Secondary Employment name/address, if applicable (Street, City and State) ___________________________________________________________ Position_________________________________ Salary____________ Starting Date _____________ Hours/wk________ Months/year_________ Supervisor Name __________________ Phone ____________ Email ______________________________ Previous employer name address _______________________________________ If current employment is not local, indicate what your local employment will be Employment name/address (Street, City and State) ________________________________________________________ Position_________________________________ Salary____________ Starting Date _____________ Hours/wk________ Months/year_________ Supervisor Name ___________________________ Phone _________________ Previous employer name address _______________________________________ Other income amounts and source(s), including food stamps, social security other public assistance and child support ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Monthly income total (before taxes and other deductions _____________________________ Net monthly income total (after taxes and other deductions) _______________________ Have you had any accounts with the following local utility companies? Gas and electric ___________ Phone_____________ Water____________ Garbage________ Banking References Savings __________________________________ Account#_____________________ Approx. bal_______ Checking _________________________________ Account#_____________________ Approx. bal_______ Installment obligations / Child support / Alimony 1. Name__________________________ Purpose__________________ Pymt/mo __________________ Current balance_________________________ Final payment date________________________ 2. Name__________________________ Purpose__________________ Pymt/mo __________________ Current balance_________________________ Final payment date________________________ 3. Name_____________ ____________ Purpose__________________ Pymt/mo __________________ Current balance_________________________ Final payment date________________________ Personal reference Name ___________________________________________ How/why this person knows you ______________________________________ Address/Phone ______________________________________________________ Nearest Relative Name _____________________________________________ Relationship to you ________________________________________ Address/Phone ___________________________________________________ How did you find out about this vacancy? _______________________________________________ This section of questions for Section 8 applicants only: How much of your rent do your currently pay ? ________________________________ First name, last name, phone number, extension of case worker __________________________________________________________________________________ How much of the rent will you be paying? _______________________________________________ The deposit is equal to one month's rent. When will you have the money for the deposit ? ____________ The undersigned promises that all statements above are true and authorize verification of all information given. If I was (we were) asked to pay an application fee, 1) if this application results in a lease, the application fee will be applied to the security deposit. 2) if the rental application is rejected, the application fee will be refunded unless the I (we) have made one or more materially false statements on this application. Examples of materially false statements include, but are not limited to, not reporting a prior eviction, misrepresentation of employment, and providing an incorrect name as a previous landlord. (A prior eviction does not necessarily disqualify the applicant.) Signed___________________________________________ Date _______________________________ Signed___________________________________________ Date _______________________________ Signed___________________________________________ Date _______________________________