RENTAL APPLICATION

RENTAL APPLICATION

Date: _______(1)__________

Application is hereby made to rent premises generally described as

______________________(2)___________________________ for a term of ______(3)_______

and ending the ________(4)__________ day of ____________(5)______, __________(6)

______, for which monthly rental shall be $____(7)____, payable in advance, and for which a

security deposit of $____(8)____ shall be due prior to occupancy of the above-described

premises.

A deposit of $_________(9)__________ is made herewith on account of the first month's

rent, with the understanding that if this application is accepted and the applicant fails to execute a

lease before the beginning date specified above, or to pay the balance due as first month's rent,

said payment will be forfeited as liquidated damages.

It is also understood that if this application is not accepted, or if the premises are not

ready for occupancy by the applicant on the date specified above, said deposit shall be refunded

to the applicant forthwith, upon applicant's request.

APPLICANT

Name: __________________________________(10)

___________________________________

Present Address: ___________________(11)_____________________ How Long? ____(12)

___

Previous Address: __________________(13)______________________ How Long? ___(14)

___

Married: ____(15)____ Spouse's Name: ______________________(16)

____________________

Children? _______(17)_______ How Many? _______(18)_______ Ages? ________(19)_______

Pets? _______(20)_______ What Kind? ________(21)_________ How Many? ______(22)

_____

YOUR EMPLOYMENT

Employer: _______________________________(23)

___________________________________

Employer Address: ________________________(24)

___________________________________

Supervisor: ____________(25)______________ Bus. Phone: ____________(26)

_____________

How Long on Present Job? __________(27)____________ Annual Income: ______(28)_______

SPOUSE'S EMPLOYMENT

Employer: _______________________________(29)

___________________________________

Employer Address: ________________________(30)

___________________________________

Supervisor: _____________(31)_____________ Bus. Phone: ____________(32)

_____________

How Long on Present Job? ________(33)_________ Annual Income: ________(34)__________

REFERENCES

Bank: _________________(35)___________________ Phone: ___________(36)____________

Personal Reference: _________(37)_______________ Phone: ___________(38)____________

Credit Reference: ____________(39)______________ Phone: ____________(40)

____________

Credit Reference: ____________(41)______________ Phone: ____________(42)

____________

______________(43)_____________

The information provided herein may be used by the landlord or his agent to determine

whether to accept this application. Upon written request within 30 days, the landlord or his agent

will disclose to applicant in writing the nature and scope of any investigation landlord has

requested, and will, if this application is refused, state in writing the reason for said refusal.

Accepted ________ Refused ________

NOTICE

The information in this document is designed to provide an outline that you can follow

when formulating business or personal plans. Due to the variances by many local, city, county

and state laws, we recommend that you seek professional legal counseling before entering into

any contract or agreement.


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