LEASE APPLICATION FOR: Date: 200

Address: Apt. #

Rent per month $ Term of Lease Start End

Application must be completed in full

No. Adults No. Children Ages Any Pets

Applicant’s full name Date of Birth Soc. Sec. #

Present address City

State Zip Home Tel. Cell

Name of
present landlord Phone No.
How long at
present address Reason for leaving Monthly rent
Your previous
address City State
No. of years at
previous address Reason for leaving Monthly rental

Present employer’s name

Address Phone No.

No. of years
Employed Position held Annual salary
Other current income
(Describe fully)

Total income
Previous employer’s
Name and city Phone No.
No. of months or years
Employed Position held Annual Salary

Name of Bank Address City

Checking account no. Savings account no.

Credit Cards (please list all)

 EMPLOYMENT REFERENCES

Your Supervisor’s Name Phone No.

College ot Tech List

School attended Graduation Date Honors

1. I understand you may choose to verify information on myself including requesting reports from credit reporting agencies. 2. The landlord assumes no
responsibility to the applicant for delay in giving possession due to failure of present occupant to vacate at termination of lease, or for any other reason,
except that the applicant will be credited with an allowance equal to the daily amount of the rent, multiplied by the actual number of days for which
possession cannot be given, and the tenant agrees to accept the lease subject to such condition.

In case of emergency contact:

Name Relationship

Office No. Cell No. Home No.

Additional emergency contact:

Name Relationship

E-mail address Signature of Applicant

 Please Print Clearly

LIST ALL PEOPLE WHO WILL LIVE IN THE APARTMENT

Relationship Date of Birth

Full Name

Soc. Sec. #

Full Name

Soc. Sec. #

Full Name

Soc. Sec. #

Full Name

Soc. Sec. #

Full Name

Soc. Sec. #

Do you currently have a lease? Yes No

What date does it end?

Have you ever declares bankruptcy? Yes No

Have you ever paid rent late? Yes No

If yes, please explain

Date: Signature:

Date: Signature: