Rental Application Property Please Select Move-in Date Monthly Rent: $ Security Deposit: $ Applicant was referred by: Please Select Real Estate Agent Newspaper Sign Internet Other Real Estate Agent Name Real Estate Agent Phone If other, please list source. Is there a co-applicant?YesNo (If yes, co-applicant must submit a separate application.) Personal Information First Name Middle Name Last Name Former Last Name Email Home Phone Work Phone Mobile/Pager Soc. Sec. No. Driver License No. Driver License No. State Date of Birth Height Weight Eye Color Hair Color Marital Status Please Select Single Married Divorced Citizenship (Country) Emergency Contact (Do not insert the name of an occupant or co-applicant.) First Name Last Name Street City State Zip Phone Email Other Occupants Name all other persons who will occupy the Property First Name Last Name Relationship Age First Name Last Name Relationship Age First Name Last Name Relationship Age First Name Last Name Relationship Age Applicant's Current Address Street Apt. No. City State Zip Landlord Name Landlord's Email Landlord's Day Phone Landlord's Night Phone Landlord's Mobile Phone Landlord's Fax Date Moved-In Move-Out Date Rent Reason For Move Applicant's Previous Address Street Apt. No. City State Zip Landlord Name Landlord's Email Landlord's Day Phone Landlord's Night Phone Landlord's Mobile Phone Landlord's Fax Date Moved-In Move-Out Date Rent Reason For Move Applicant's Current Employer Street City State Zip Employer Name Supervisor Phone Fax Email Start Date Gross Monthly Income Position Note: If applicant is self-employed, Landlord may require one or more previous year's tax return attested by a CPA, attorney, or other tax professional. Applicant's Previous Employer Street City State Zip Employer Name Supervisor Phone Fax Email Employed From Employed To Gross Monthly Income Position Describe other income Applicant wants considered: Vehicle Information List all vehicles to be parked on the Property Vehicle 1 Type Year Make Model License/State Monthly Payment Vehicle 2 Type Year Make Model License/State Monthly Payment Pet Information Please list any pets (dogs, cats, birds, reptiles, fish, and other pets) that will be kept on the Property Pet 1 Type & Breed Name Color Weight Age in Years Gender Neutered? Please Select Yes No Declawed? Please Select Yes No Rabies Shots Current? Please Select Yes No Pet 2 Type & Breed Name Color Weight Age in Years Gender Neutered? Please Select Yes No Declawed? Please Select Yes No Rabies Shots Current? Please Select Yes No Additional Information Will any waterbeds or water-filled furniture be on the Property? Yes No Does anyone who will occupy the Property smoke? Yes No Will Applicant maintain renter's insurance? Yes No Is Applicant or Applicant's spouse, even if separated, in military? Yes No If yes, is the military person serving under orders limiting the military person's stay to one year or less? Yes No Has Applicant ever: Been evicted? Yes No Been asked to move out by a landlord? Yes No Breached a lease or rental agreement? Yes No Filed for bankruptcy? Yes No Lost property in a foreclosure? Yes No Had any credit problems (including any outstanding debt (e.g. student loans or medical bills)), slow-pays or delinquencies? Yes No Been convicted of a crime? Yes No Is any occupant a registered sex offender? Yes No Are there any criminal matters pending against any occupant? Yes No Is there additional information Applicant wants considered? Yes No Additional comments Authorization Applicant authorizes Landlord and Landlord's agent, at any time before, during, or after any tenancy, to: obtain a copy of Applicant's credit report; obtain a criminal background check related to Applicant and any occupant; and verify any rental or employment history or verify any other information related to this application with persons knowledgeable of such information. Notice of Landlord's Right to Continue to Show the Property: Unless Landlord and Applicant enter into a separate written agreement otherwise, the Property remains on the market until a lease is signed by all parties and Landlord may continue to show the Property to other prospective tenants and accept another offer. Privacy Policy Landlord's agent or property manager maintains a privacy policy that is available upon request. Fees: Applicant submits a non-refundable fee of $40.00 to Professional Asset Management (entity or individual) for processing and reviewing this application. Applicant submits an application deposit of $100.00 to be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed. If applicant withdraws application at any point while in process then all application and hold fees paid are forfeited. Acknowledgment & Representation: Signing this application indicates that Applicant has had the opportunity to review Landlord's tenant selection criteria, which is available upon request. The tenant selection criteria may include factors such as criminal history, credit history, current income and rental history. Applicant understands that providing inaccurate or incomplete information is grounds for rejection of this application and forfeiture of any application fee any may be grounds to declare Applicant in breach of any lease the Applicant may sign. Applicant represents that the statements in this application are true and complete. Type Your Name
