Rental Application

Phone

This field is for validation purposes and should be left unchanged.

Applicant Name.*

First Last

Co-applicant Name

First Last

Additional Occupants

Today's Date

Property Address

Lease Term (Months)

Lease Begin Date

Monthly Amount ($)

Each Applicant(s) agrees to and does hereby pay to Agent the non-refundable processing fee of $35.00 to include a Credit Report in order to verify the information set forth in this Application. Applicant(s) authorizes Agent to obtain data for same. An earnest money deposit in the amount of the first month's rent is made herewith to be held by Property Specialists, Inc. with a clear understanding that this Application, including each prospective occupant, is subject to approval and acceptance by Owner/Agent; and that within THREE (3) DAYS of acceptance by Owner/Agent, the Applicant(s) shall execute a lease. If Applicant(s) does not execute a lease, the deposit shall be returned to Applicant(s) less actual damages and expenses suffered, including (but not limited to) lost rental income, Agent's commission and cost of advertising. If this Application is not approved and accepted by Owner/Agent, the deposit shall be refunded.

Applicant Information

Social Security #

Date of Birth

Current Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone (work)*

Phone (cell)

Email*

Resident Since

Monthly Payment

Current Landlord

Landlord Phone

Previous Landlord (if current residence is less than two years)

Phone

Current Employer

Employer Phone

How long?

Salary

Position

Co-applicant Information.

Social Security #

Date of Birth

Current Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone (work)

Phone (cell)

Email

Resident Since

Monthly Payment

Current Landlord

Landlord Phone

Previous Landlord (if current residence is less than two years)

Phone

Current Employer

Employer Phone

Current Supervisor

First Last

Phone

How long?

Salary

Position

Names of all other occupants to live in house

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Financial History

Bank Name

Account Type

Bank Name

Acount Type

Monthly Payments (Payment duration of 3 months or more, e.g., Auto, Mortgage, Alimony, Dependent, Support, Taxes, Garnishments)

To

For

Amount

To

For

Amount

Has applicant ever filed for bankruptcy?

Date Filed

Date Granted

Where Filed

Has Applicant/Co-Applicant ever been evicted or had judgment issued against him/her?

Yes
No

Are there any outstanding judgments against Applicant/Co-Applicant?

Yes
No

Has Applicant/Co-Applicant had property foreclosed upon or given title or deed in lieu thereof in the past 7 years?

Yes
No

Is Applicant party to a lawsuit?

Yes
No

Is Applicant obligated to pay alimony, child support, or separate maintenance?

Yes
No

Is Applicant co-maker or endorser on a note?

Yes
No

If Applicant answered yes to any of the above questions, please attach an explanation.

Additional Information

Automobile(s), Motorcycle, Van, Truck, Trailer, camper, RV, Boat, Commercial vehicle, etc.

Applicant

Make

Model

Year

Color

State

License Plate Number

Co-applicant

Make

Model

Year

Color

State

License Plate Number

Pets?

Yes
No

Type?

Size?

Emergency Contacts (Other than Co-applicant)

Name

First Last

Phone

Name

First Last

Phone

I/WE REPRESENT THAT THE PREMISES SHALL NOT BE USED FOR ANY ILLEGAL OR RESTRICTED PURPOSE(S) AND CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I HAVE READ AND AGREE WITH THE ABOVE TERMS OF SERVICE.

Please Initial

Rental Application Form

Applicant Information

Co-applicant Information.

Names of all other occupants to live in house

Financial History

Additional Information

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