TENANT Information:
#1 Name(Last, First, M.I.)
Social Security Number
Driver’s Lic. # Driver License State:
Date of Birth:
Present Address:
City, State, Zip:
Business Ph. #: Home Ph. #:
Emergency Ph. #: Fax Ph. #:
Email Address:
Spouse’s Information:
Name(Last, First, M.I.)
Social Security Number
Driver’s Lic. # Driver License State:
Date of Birth:
Employer Information:
Company Name:
Company Address:
Supervisor’s Name:
Company Phone #:
Supervisor’s Phone #:
Length of Employment: Position Held:
Monthly Income:
Current Landlord’s Information:
Landlord’s Name:
Bus. Phone #:
Cell Phone #:
Address:
Current Residence Rent Amount:
Current Move in Date: Move Out Date:
Landlord’s Information Previous to Current Landlord:
Landlord’s Name:
Bus. Phone #:
Cell Phone #:
Address:
Current Residence Rent Amount:
Current Move in Date: Move Out Date:
Number of Occupants to Occupy Property?
Name, Relationship & Age:
Name, Relationship & Age:
Name, Relationship & Age:
Name, Relationship & Age:
EMERGENCY INFORMATION:
Next of Kin:
Relationship:
Home Phone #:
Business Phone #:
Home Address:
City, State, & Zip:
NUMBER OF VEHICLES:
Cars: License Plate #: License Plate #:
Boats: Trailer Lic Plate #: Trailer Lic Plate #:
R.V.: License Plate #: License Plate #:
Other: License Plate #: License Plate #:
PETS:
Number of Pets:
Breeds: , , ,
Weight: _____ , ______, ______, ______ .
Age: ______, ______, ______, ______.
Declawed?: ______, ______, ______, ______.
Neutered?: ______, ______, ______, ______.
In or Out Door?: ______, ______, ______, ______.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Will any Waterbeds be on property? Yes No
Will Applicant obtain & maintain Renters Insurance? Yes No
EVER ARRESTED? Yes No
EVER EVICTED? Yes No
EVER FORECLOSED ON? Yes No
EVER FILED BANKRUPTCY? Yes No
If you answered “YES” to any question above, please explain: (Use back of page if necessary)
______________________________________________________________________________
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Applicant understands that providing false information in this application is grounds for rejections.
A NON-REFUNDABLE fee for a credit and back ground check of $25.00 is hereby tendered by Applicant to Landlord's Agent. The undersigned represents that the above statements are true and complete.
FAIR CREDIT REPORTING ACT COMPLIANCE NOTICE
If an adverse action is taken with respect to this application due to any information contained in a consumer report, the Fair Credit Reporting Act requires that the consumer be notified of the following:
Consumer Reporting Agency Used: EXPERIAN, 955 AMERICAN LANE, SCHAUMBURG, ILLINOIS, 60173. (PHONE # 1-(800) 831-5614).
The consumer reporting agency did not make the decision to take the adverse action and is unable to provide the consumer the specific reasons why the adverse action was taken.
The applicant has the right to obtain, under section 612 [S 1681j], a free copy of the consumer report on the applicant from the consumer reporting agency upon request within 60 days and dispute the accuracy or completeness of any information the consumer report agency furnished.
Whenever credit for personal, family, or household purposes involving a consumer is denied or the charge for such credit is increased either wholly or partly because of information obtained from a person other than a consumer reporting agency bearing upon the consumer’s credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living, the use of such information shall, within a reasonable period of time, upon the consumer’s written request for the reasons for such adverse action received within sixty days after learning of such adverse action, disclose the nature of the information to the consumer. The user of such information shall clearly and accurately disclose to the consumer his right to make such written request at the time such adverse action is communicated to the consumer.
APPLICANT HEREBY AUTHORIZES LANDLORD OR LANDLORD’S AGENT TO OBTAIN A COPY OF APPLICANT’S CREDIT REPORT, VERIFY APPLICANT’S RENTAL HISTORY, EMPLOYMENT HISTORY, AND OBTAIN OTHER INFORMATION RELATED TO THIS APPLICATION. APPLICANT ALSO ACKNOWLEDGES RECEIPT OF THE FAIR CREDIT REPORTING ACT NOTIFICATIONS.
Tenant Signature Date
APPROVED ________ DENIED: ___________
Notified: Applicant (Name):
Date: _____________ Time:________
Method of Notice: By: