Rental Application

Applicant's employment


Spouse's employment

Present Landlord or mortgage company

Previous Landlord or mortgage company

Personal References





Have any of the occupants listed above ever been:

Screening Fee

Each applicant shall pay a nonrefundable screening fee of $ . The application screening fee is not part of a security deposit, advance fee or rent. Upon request, Applicant may be provided a copy of the consumer credit report for which Owner/Agent obtained in connection with the Application to rent and will be provided if the credit report is used as the basis of an adverse action. Applicant herein authorizes the Owner/Agent to use these funds to obtain and review information herein, criminal background checks, credit checks, and other screening materials and tools.

Agreement & Authorization Signature

Applicant represents the statements are true and correct and hereby authorizes Owner/Agent to verify these items and obtain credit and/or criminal background checks to be made and to furnish additional credit references or other legal information upon Owner’s/Agent’s request. Applicant certifies under penalty of perjury that the foregoing is true and correct. Applicant agrees that the Owner/Agent is authorized to investigate the information that is provided herein and to inquire and study the information in connection with establishing Applicants qualifications to rent. Applicant further acknowledges and agrees that misstatements or misrepresentations of the foregoing information is a non-curable breach of any rental agreement that may be entered into with Owner/Agent. Applicant understands that any discrepancy or lack of information may result in the rejection of this application. Applicant understands that this is an application for a residential rental unit and does not constitute an offer to rent or a rental or lease agreement in whole or part.