Lease- Rental Application

Applicant Information:
Name 1 Phone
Name 2 Phone

Current Address City
State Zip
Date of Birth 1 Social Security 1 Drivers License 1
Date of Birth 2 Social Security 2 Drivers License 2
Student School Student ID

Check the type of apartment you want:
1 Bedroom 2 Bedroom

Other occupants or family members who will occupy the unit:
Occupant Name Relationship
Occupant Name Relationship

Employment History or Source of Income:
Current Employer, School, or Income Source
Employer Address City
State Zip
Phone Length of Employment Months Years Date Enrolled
Gross Earnings or Other Income

Current Residency
Current Landlord Have you ever been evicted? Yes No
Address City
State Zip
Phone Current Monthy Rent Length of Residency Months Years
Have you or any person(s) staying with you ever been convicted of a crime? Yes No Nature of Offense

I hereby certify that all the information given above is correct to the best of my knowledge. I hereby authorize the Landlord to check and verify any Civil Criminal information including my previous rental history, employment, and credit as part of this application process without liability. I understand that this is not to be construed as a rental contract or lease.

SIGNATUE: _____________________________________ DATE:_____________________________