Rentals – My Blog

Rental Application

Personal Information

Full Name Birth Date Driver’s License # / State Phone # Email

Roommates / Other Occupants

Full Name	Birth Date	Relationship to You

Rental History

	Current Address	Previous Address	Previous Address
Street Address / Unit No.
City, State, Zip
Manager/Owner Name
Rent Cost

Income / Employment History

	Current Employer	Previous Employer	Previous Employer
Employed by
Monthly Income

Emergency Contact Information

Name Phone # Relationship

Other Information

Have you ever been evicted? Yes No

If yes, when & why

Do you have pets? Yes No

If yes, please describe

Agreement & Consent to Background Check

I believe that the statements I have made are true and correct. I authorize the verification of this information and understand that this is an application for a rental unit and does not constitute a rental agreement.

Signature Date

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