current employment                                 prior employment



                                                              current address                                          prior address



 List all of your vehicles:

List Assets:

CREDIT INFORMATION Please list all your financial obligations:

GENERAL INFORMATION Circle answer that applies 

•                     Do you smoke? YES   NO 

•                     Do you have any pets? YES    NO 

•                     Have you ever filed for bankruptcy? YES   NO 

•                     Do you have any musical instruments? YES   NO 

•                     Do you have any water­filled furniture or do you intend to    use  YES   NO          water filled furniture in the apartment? 

•                     Have you ever been convicted for selling, possessing, YES     NO   distributing or manufacturing illegal drugs or convicted of any other crime? 

•                     Have you ever been evicted for non­payment of rent or any YES NO other reason? 

Please explain any “yes” answers to the above questions: 

Why are you leaving your current residence?____________________________________________________ 

The applicant hereby applies to rent/lease Apartment #_________at___________________________ ________________________________for $__________ per month, and upon owner’s approval agrees to enter into a Rental Agreement and/or Lease and pay all rent and security deposits required before

 occupancy. 

An application fee of $__________ is hereby submitted for the cost of processing this application, to 

obtain credit history and other background information.

Applicant represents that all information given on this application is true and correct. Applicant hereby authorizes verification of all references and facts, including but not limited to current and previous landlords and employers, and personal references. Applicant hereby authorizes owner/agent to obtain 

Unlawful Detainer, Credit Reports, Telechecks, and/or criminal background reports. Applicant agrees to furnish additional credit and/or personal references upon request. Applicant understands that incomplete or incorrect information provided in the application may cause a delay in processing which may result in denial of tenancy. Applicant hereby waives any claim and releases from liability any person providing or obtaining said verification or additional information. 

Applicant:________________________________________Date:____________________________ (Signature required)





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