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RENTAL APPLICATION
Equal Housing Opportunity
The undersigned hereby makes an application to rent unit located at:
______________________________. Anticipated move date of ________at a monthly rent of $________ and security deposit of $____________.
PLEASE TELL US ABOUT YOURSELF
Full Name____________________________________Home Phone ( ) _________________________Date of Birth_______________________________ Social Security #____________________________ Email Address:________________________(optional) Other Phone ( ) _______________________Co-Applicant Name___________________________
Co-Applicant Date of Birth______________________ Social Security #_____________________________
Names of Dependents_______________________________________________________
Dependents Date of Birth ________________________________________________________________
List All Pets____________________________________________________________________________
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address_______________________Apt#___ City__________________ State______ Zip________ Month/Year Moved In____________ Reasons for Leaving_________________________Rent $__________Owner/Agent_____________________________________Phone ( ) ____________________________Previous Address ___________________________________________Rent $____________
Owner/Agent___________________________________Phone ( ) ____________________________
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you declared bankruptcy in the past seven (7) years? Yes_____ No_____Have you ever been evicted from a rental Residence? Yes_____No_____ Have you had two or more late rental payments in the past 2 years? Yes_____ No_____Have you ever willfully or intentionally refused to pay rent when due? Yes_____ No_____
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: _____Full Time _____Part Time _____Student _____Unemployed _____ Retired ______Employer___________________________________________________Dates employed________________ Employed as__________________________________Supervisor Name______________________________ Phone ( )_____________________ Salary $_______per_______. (If employed by above less than 12 months, give name & phone of previous Employer or School:_________________________________________________________.)
If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application.
Amount $___________________ Source/Contact Name____________________________________
PLEASE LIST YOUR REFERENCES
Banking / Credit Accounts:
Name_________________ Type of Account_________________ Account Number_________________ Name_________________ Type of Acount_________________ Account Number_________________
Personal Reference or Emergency Contact:
Name _______________________ Address _______________________________________
Phone _______________________ Relationship_______________________
Driver's License:
Your Driver's License Number_________________ State_________________
Vehicle Information:
Make / Model _________________Year _________________License Plate State_________________
ADDITIONAL INFORMATION:
Please give any additional information that might help owner/management evaluate this application?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Where may we reach you to discuss this application?
Day Phone # ( ) ________________ Night Phone # ( )____________________________
I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance. I’m including $10.00 per applicant for the credit report fee. As an inducement to the owner of the property and to the agent to accept this application. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application.
I hereby deposit $___________ as earnest money to be refunded to me if this application is not accepted in 5 business banking days. Upon acceptance, this deposit shall be retained as part of the security deposit. When so approved and accepted, I agree to execute a lease for 12 months before possession is given nd to pay the balance of the security deposit prior to the move in date. If the application is not approved or accepted by the owner or agent, the deposit will be refunded, the application hereby waiving any claim for damages by reason off non-acceptance which the owner or agent may reject. I recognize that as a part of yourprocedure for processing my application, and investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living.
The above information, to the best of my knowledge, is true and correct.
Please sign: X__________________________________ ________________
Name of Applicant Date
ATHORIZATION
Release of Information
I agree to permit an investigation of my credit, tenant history, banking and employment for the purposes of renting an apartment with this owner/manager. ________________________________________ Name (please print)
Return to:
Barrientos Properties
3905 Brickman Ave, Ames, IA 50010
X____________________________ ___________
Signature Date
APPLICANT: PLEASE DO NOT WRITE BELOW (FOR OFFICE USE ONLY)
Deposit of $__________________ Received by ____________________________
Date_______________
OFFICE NOTES:
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