Application is hereby made to rent premises generally described as _________________________________________________ for a term of ____ and ending the __ day of ___________, 19__, for which monthly rental shall be $________, payable in advance, and for which a security deposit of $________ shall be due prior to occupancy of the above-described premises.
A deposit of $______ 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.
Present Address: ________________________________________
How Long? _______
Previous Address: ________________________________________
How Long? ______
Spouse's Name: __________________________________________
How Many? ______________
What Kind? _________________
How Many? ___________
Bus. Phone: ________________________
How Long on Present Job? ____________________
Annual Income: ____________
Bus. Phone: _________________________
How Long on Present Job? _______________
Annual Income: _________________
Personal Reference: _______________________
Credit Reference: _________________________
Credit Reference: __________________________
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
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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