Rental Application

Rental Application :


Date: ________________

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? ______

Married: ________

Spouse's Name: __________________________________________

Children? ______________

How Many? ______________

Ages? _______________

Pets? _____________

What Kind? _________________

How Many? ___________




Employer Address:


Supervisor: _________________________

Bus. Phone: ________________________

How Long on Present Job? ____________________

Annual Income: ____________




Employer Address:________________________________________________________

Supervisor: __________________________

Bus. Phone: _________________________

How Long on Present Job? _______________

Annual Income: _________________


Bank: ___________________________________

Phone: _______________________

Personal Reference: _______________________

Phone: ______________________

Credit Reference: _________________________

Phone: _______________________

Credit Reference: __________________________

Phone: ________________________


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.

Rental Application